• Title/Summary/Keyword: 전방 불안정

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Comparison of Rotational Strength in Shoulders with Anterior Instability and Normal Shoulders Using Isokinetic Testing (등속성 검사를 통한 견관절 전방 불안정 환자와 정상인의 회전력 비교)

  • Lee, Dong-Ki;Kim, Tae-Kwon;Lee, Jin-Hyuck;Lee, Dae-Hee;Jung, Woong-Kyo
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.79-85
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    • 2012
  • Objective: It has been expected that patient with posttraumatic recurrent anterior shoulder dislocation might have limited daily life activity because of pain and apprehension of dislocation. But there have been only a small number of investigations regarding the rotator strength in this patient. The aim of this study is to find the characteristics about rotator strength of patient with posttraumatic recurrent anterior shoulder dislocation using an isokinetic testing. Method: We enrolled thirteen patients with posttraumatic recurrent anterior shoulder dislocation and fifteen sex, age-matched healthy nonathletic subjects in this controlled study. All participants were male and there were no significant differences between the two groups in age, height, weight, BMI. Isokinetic internal rotator and external rotator strength was evaluated with a Biodex Isokinetic Testing machine (Biodex Medical Systems, Shirley, NY, USA), tests were performed at 60 deg/sec and 180 deg/sec for both sides. Peak torque normalized to body weight, external rotator to internal rotator ratio, total work and fatigue were calculated for each angular velocity. The association between internal rotator and external rotator strength and shoulder instability was analyzed by comparisons with a control group. Results: Any notable differences could not be found between the two groups given all data from no symptomatic left shoulder. There were no significant differences between the two groups statistically in internal rotation strength of right shoulder. However, there has been a tendency that at all angular velocities, external rotator peak torque to body weight, total work and external rotator to internal rotator ratio were significantly lower in the anterior instability group than the control group at all angular velocities. There was no substantial difference between those groups with respect to the fatigue of external rotator and internal rotator in our study. Conclusion: The prominent characteristics of posttraumatic recurrent anterior shoulder dislocation are external rotator weakness and loss of balance with external rotator and internal rotator. Therefore selective training using this information rotator might be helpful in conservative treatment and rehabilitation.

Results of Anterior Cruciate Ligament Reconstruction with Unicondylar Arthroplasty for Medial Compartment Knee Osteoarthritis combined with Anterior Instability (전방 불안정성과 동반된 슬관절 내측 구획 진행성 관절염환자에서 전방십자인대 재건술 및 인공 관절 부분 치환술의 결과 - 3예 보고 -)

  • Lee, Chul Hyung;Song, In Soo;Ji, Jong Hun;Kim, Tae In
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.88-94
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    • 2013
  • Three cases who had medial compartment osteoarthritis of the knee (Kellgrene-Laurence grade 3 and Outerbridge grade 4) and anterior instability of the knee due to rupture of the anterior cruciate ligament in relative young ages underwent staged anterior cruciate ligament reconstruction followed by medial unicondylar arthroplasty in 2 cases and simultaneous anterior cruciate ligament reconstruction and unicondylar arthroplasty. We evaluated clinical results some kinds of preoperative and postoperative International Knee Documentation Committee (IKDC), Lysholm score and last follow-up hospital for special surgery (HSS), knee society score (KSS). We consider that medial unicondylar arthroplasty with staged or simultaneous anterior cruciate ligament reconstruction is very good option of the treatment for the anterior instability and pain from advanced arthritis.

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Stabilization in the Anterior Shoulder Instability' Where Do We Stand Today? (견관절 전방 불안정성에서 치료방침의 결정)

  • 이용걸
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2004.11a
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    • pp.112-116
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    • 2004
  • 전방 탈구인 경우 첫탈구이거나 생애에 몇번만 탈구를 경험하고 일상생활에 별 지장이 없다면 보존적으로 치료하는 것이 바람직하다. 다만 early surgey가 요구되는 경우는, 첫탈구가 teen aged이면 관절경적 수술을, 골편이 큰 Bankart병변이 있는 첫탈구는 수술하는 것이 좋다. 전방 불안정성인 경우, collision sports는 개방술로, non-athletes이거나 throwing 또는 contact sports는 관절경술로 시행해 주는 것이 바람직하다. 우리가 명심하여야 할 것은 전방 불안정성을 다루는데 환자의 입장에서 서야 한다는 것이다. 의사의 능력 정도나 욕망보다도 환자의 상태, 활동 정도와 환자의 요구에 맞추어 환자를 치료하여야 한다.

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Recurrent Traumatic Glenohumeral Instability associated with Glenoid Bone Defect (관절 와 골 결손이 동반된 재발성 견관절 외상성 불안정증 - 3례 보고 -)

  • Tae, Seok-Gi;O, Jong-Su;Im, Mu-Jun
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2009.03a
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    • pp.224-224
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    • 2009
  • 견관절 전방 외상성 불안정증에서 관절 낭-순 재건술은 재발성 불완정증 예방 및 기능 회복에 있어 매우 성공적인 술식이다. 그러나 관절 와의 30 % 이상의 심한 골 결손이 존재 할 때 관절 낭-순 재건술 만으로는 성공적인 결과를 가져오기 힘들다. 본 연구는 관절 와의 심한 골 결손을 가진 재발성 전방 외상성 불안정성 견관절에서 관절외 자가 장골 이식으로 보강한 관절 낭-순 재건술의 술기와 결과를 보고하고자 한다.

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돔형 쉘의 구조불안정 문제를 통하여 본 제3의 과학에의 교훈

  • 김승덕
    • Computational Structural Engineering
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    • v.9 no.2
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    • pp.23-27
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    • 1996
  • 오늘날 기술혁신 전쟁의 최전방에 대응하는 것이 불연속 및 불안정 문제를 포함하는 비선형문제이고, 비선형문제에도 도전하고 이를 극복하기 위한 최첨예 무기는 바로 컴퓨터라 할 수 있다. 그러나 인간이 본질인 시행착오를 생각해 보면, 오늘날 범람하고 있는 컴퓨터로부터의 출력 데이터는 매우 위험한 존재가 될 수도 있다. 본 고에서는 제3의 과학시대가 열린 오늘날, 범람하는 많은 컴퓨터 출력 데이터의 위험성을 자각하기 위해 돔형 쉘의 구조불안정 문제에 얽힌 재미있는 한 예를 설명하고, 이러한 오류에 대응하기 위한 검정방안을 제시한다.

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Comparison of Balance Ability between Stable and Unstable Surfaces for Chronic Stroke Patients (불안정 지지면과 안정 지지면에서의 만성 뇌졸중 환자의 균형 능력 비교)

  • Lee, Ji-Yeun;Roh, Hyo-Lyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.8
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    • pp.3587-3593
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    • 2011
  • This study was to investigate the balancing and clinical abilities using stable and unstable surface of stroke patients who surface changes in balance of body. The subjects of this study were 30 stroke patients(16 males and 14 females). They were separated into two groups and did balance reinforcing exercise on stable and unstable surfaces for five times a week for six weeks. To evaluate their balancing ability, they performed functional standing balance test, functional forward arm stretching test. performance-oriented mobility assessment was performed. The balancing exercises were modified from preceding studies and consisted of 6 difference exercises. The functional standing test with open and close eyes and performance-oriented mobility assessment, the unstable surface exercise group and the stable surface exercise group improved significantly. The forward arm stretching test was the unstable surface exercise group improved. This study found that the balancing exercise on unstable surface was more effective than on stable surface for stroke patients. Thus, exercise on unstable surface has more positive effects on the improvement of balancing abilities of stroke patients.

Recurrent Traumatic Glenohumeral Instability Associated with Glenoid Bone Defect - 3 Case Report - (관절 와 골 결손이 동반된 재발성 견관절 외상성 불안정증 - 3례 보고 -)

  • Tae, Suk-Kee;Oh, Jong-Soo;Kim, Jin-Young
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.76-79
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    • 2009
  • Purpose: Capsulolabral reconstruction in a traumatic anterior instability of the glenohumeral joint is successful not only for the prevention of recurrent instability but also for the restoration of function. Materials and Methods: However, a capsulolabral procedure alone cannot guarantee a successful result when there is severe bone loss of the glenoid. Results: We report the surgical technique and results of capsulolabral repair and extraarticular bone block with an autogenous iliac crest graft performed on three cases (all male, average age 28 years, minimum follow-up 12 months) with traumatic anterior instability associated with more than 30% glenoid bone loss.

Latarjet Operation for Anterior Shoulder Instability with Glenoid Bone Defect (관절와 골 결손을 동반한 견관절 전방 불안정증에 대한 Latarjet 술식)

  • Cho, Seung-Hyun;Cho, Nam-Su;Yi, Jin-Woong;Choi, Il-Hun;Kwack, Yoon-Ho;Rhee, Yong-Girl
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.189-198
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    • 2009
  • Purpose: We wanted to evaluate the clinical results of the Latarjet procedure for treating anterior shoulder instability combined with a glenoid bone defect. Materials and Methods: Between Oct. 2006 and May. 2007, fourteen patients underwent a Latarjet operation to treat their anterior shoulder instability combined with a glenoid bone defect. The mean follow-up period was 15 months (range: 12 to 19 months), and the average age at the time of surgery was 29.9-years-old (range: 19 to 44 years). There were 13 males and 1 female. Eight patients exhibited involvement of the right shoulder. The dominant arm was involved in 8 patients. Six patients had undergone a previous arthroscopic Bankart repair before their Latarjet operation and 2 patients had a history of seizure. Results: The average Rowe score improved from 51.8 to 80.2 with 9 excellent, 4 good, and 1 fair results. The average Korean shoulder score for instability improved from 61.6 to 82.1 postoperatively. The active forward flexion and external rotation at the side of the involved shoulder was an average of $8^{\circ}$ and $16^{\circ}$ less than that of the uninvolved shoulder. The muscle strength of the involved shoulder measured 78.7% in forward flexion and 82.5% in external rotation, as compared with that of the uninvolved shoulder. There was 1 case of dislocation, 1 transient subluxation, 2 fibrotic unions, 1 resorption of the transferred coracoid process, 1 intraoperative broken bone, 1 transient musculocutaneous nerve injury and 1 case of stiffness. Conclusion: The Latarjet procedure for treating anterior shoulder instability combined with a significant glenoid defect effectively restores function and stability through extending the articular arc at the expense of external rotation. We should be cautious to avoid or detect complications when performing coracoid transfer.