• Title/Summary/Keyword: 전방 전위

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Transpatellar Cannulated Screw Fixation of Displaced Tibial Intercondylar Eminence Fractures (전위성 경골 과간 융기부 골절의 슬개골 하단을 통한 삽관 나사못 고정술)

  • Nha Koung Wook;Jung Byung Hyun;Suh Jin Soo;Suk Seung Yeub;Park Gyu Won;Chae Dong Ju
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.25-30
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    • 2002
  • Purpose : To evaluate the clinical results of displaced tibial intercondylar eminence fractures which were treated with transpatellar cannulated screw fixation. Materials and Methods : Ten patients with displaced tibial intercondylar eminence fractures were treated between December 1998 and May 2001 and then followed up for more than one year. They were treated arthroscopic reduction and fixation of fracture site by cannulated screw through the hole of nonarticular surface of inferior patella. They were prospectively evaluated with regard to their clinical and radiologic results. Results : Radiologic unions occurred at an average of 9.2 weeks. Average anterior displacements were 1.8 mm in stress x-rays and 1.1 mm in KT-2000 arthrometer. Average loss of extension was $4.1^{\circ}$. Functional results were excellent in 7 cases and good in 3 cases. Conclusion : Arthroscopic transpatellar cannulated screw fixation is one of the useful methods for the treatment of displaced tibial intercondylar eminence fractures.

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Clinical Results of Footprint Restoration Anterior Cruciate Ligament Reconstruction with Remnant Preservation (잔여부 보존술식을 이용한 고유부착부 재현 전방십자인대 재건술의 임상결과)

  • Chung, Hyun-Min;Seo, Young-Jin;Song, Si Young;Cha, Myoungsoo
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.537-546
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    • 2019
  • Purpose: Anteromedial (AM), posterolateral (PL), anterior, and posterior remnant preserving anterior cruciate ligament (ACL) reconstructions were conducted on patients with partial ACL tears based on the arthroscopic findings. The clinical results of the four groups were compared. Materials and Methods: This study included 98 patients who underwent a remnant preserving ACL reconstruction from January 2013 to June 2016 and could be followed-up for at least two years. The subjects were categorized into four groups according to the selective bundles reconstructed: group A, anteromedial selective bundle reconstruction; group B, posterolateral selective bundle reconstruction; group C, anterior bundle reconstruction; and group D, posterior bundle reconstruction. The preoperative and postoperative anterior translation from the stress X-ray, International Knee Documentation Committee Subjective Knee Form (IKDC SKF) score, Lysholm score, and hospital for special surgery (HSS) score were compared. Results: All four groups showed significant improvement in anterior translation on the stress X-ray conducted with knees at 15° flexion, IKDC SKF score, Lysholm score, and HSS score postoperatively (in all groups, p<0.001). No intergroup differences were observed in terms of the functional outcomes except that preoperative IKDC SKF score was higher in the C group than in the A group (p=0.021), and the preoperative Lysholm score was higher in the B group than in the A group (p=0.03). Conclusion: After the AM, PL, anterior, and posterior remnant preserving ACL reconstructions, all four groups showed satisfactory results in terms of the anteroposterior stability and functional knee scores with no significant intergroup differences.

Snapping Triceps Syndrome with Dislocation of the Ulnar Nerve - Usefulness of Dynamic Ultrasonography - (척골 신경 탈구와 동반된 발음성 삼두근 증후군 - 동적 초음파 검사의 유용성 -)

  • Jeong, Ung-Gyo;Park, Sang-Won;Song, Dong-Ik;Lee, Sun-Hyeok
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2008.03a
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    • pp.171-171
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    • 2008
  • 발음성 삼두근 증후군은 주관절을 굴곡하거나 신전할 때 삼두근 말단부 일부와 척골 신경이 내상과 전방으로 탈구되는 드문 질환이다. 이학적 검사 만으로는 다른 질환으로 오진되는 경우가 많아 정확한 진단이 필수적이며 확진을 위하여는 척골 신경 및 삼두근의 비정상적인 움직임을 관찰할 수 있는 영상 검사가 필요하다. 초음파 검사는 자기 공명 영상 촬영 등 다른 검사에 비해 간편하고 효과적으로 연부 조직의 동적 검사를 시행할 수 있는 장점이 있다. 저자들은 발음성 삼두근 증후군 환자를 동적 초음파 검사를 사용하여 진단하고 척골 신경 전방 전위술 및 삼두근 내두의 이전술을 시행하여 치유하였기에 문헌 고찰과 함께 초음파 검사의 유용성을 보고하고자 한다.

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ROLE OF NITRIC OXIDE AND DISTRIBUTION OF NITRIC OXIDE SYNTHASE IN THE GUSTATORY SYSTEM (미각계에서 산화질소의 역할과 산화질소 합성효소의 분포)

  • Kim, Young-Jae;Kim, Won-Jae;Ryu, Sun-Youl
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.3
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    • pp.262-269
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    • 2000
  • 말초 미각계 및 중추 미각계에서 산화질소의 역할과 그것의 합성효소의 존재는 아직 규명되지 않고 있다. 본 연구는 말초미각계인혀와 미각구심성신경 그리고 중추미각계인 뇌간고속핵에서 산화질소 합성효소의 분포 및 면역조직화학 방법과 고삭신경의 extracellular recording 뇌간고속핵 절편 whole cell patch 방법으로 조사하였다. 신경성 산화질소 합성효소는 혀의 전방에 위치한 심상유두와 유곽유두에 약하게 존재하였으며 미뢰주위와 결체조직에 존재하는 신경섬유 및 혀의 상피층에 풍부하게 존재하였다. 혀에 소금물을 가하여 증가된 고삭신경의 복합전위는 산화질소 유리제인 SNP에 의해 증가되었으며 내인성 산화질소 합성효소 억제제인 L-NAME와 soluble guanylate cyclase 억제제인 ODQ에 의해 억제되었다. 문측 연수에 존재한 문측 고속핵과 진전핵에서 nNOS가 풍부하게 존재하였다. 문측 고속핵의 신경들은 안정막전위가 $-48{\pm}52mV$였고 활동전위의 크기는 $74{\pm}11mV$였다. SNP에 의해 뇌간 고속핵 신경들이 탈분극되었으며 current clamp하였을 때 활동전압의 빈도가 증가하였다. 또한 SNP에 의한 문측 고속핵의 탈분극과 활동전압 빈도증가는 L-NAME와 ODQ에 의해 감소되었다. 이상의 실험결과는 산화질소 합성효소가 혀와 뇌간고속핵에 존재하며 여기서 유리된 내인성 산화질소가 말초성 및 중추성 미각기전에 관여하리라 사료된다.

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Comparison between Conservative Treatment of partial ACL Rupture and Reconstructive Surgery with BPTB Autograft in ACL Rupture (전방 십자 인대 파열후 자가 슬개건을 이용한 재건술군과 부분 손상후 보존적 치료군의 비교)

  • Lee Dong Chul;Lee Su Ho;Kim Dong Han
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.2
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    • pp.131-137
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    • 2002
  • Purpose: To evaluate and compare the functional results, activity status, and anterior stability between conservative group with partial ACL injury and reconstruction group with bone-patellar ten-don-bone autograft in ACL total rupture. Materials and Methods: Thirty-eight patients with ACL injury were diagnosed and treated with arthroscopy and followed for more than two years. The number of patients with partial injury was 12(mean age; 38.3) and reconstruction group was 26 (mean age; 25.3). Objective stability was estimated under anterior loading of 15 lb and 20 lb by KT-2000 Arthrometer (MED metric, USA). Functional evaluation using Lysholm score and Tegner activity score were performed. Results: Average functional score of Lysholm was 88.5 in partial injury group and 89.3 in reconstruction group. Average score of Tegner was 5.3 in partial injury group and 5.1 in reconstruction group(P<0.05).Average anterior displacement compared with normal side. Under loading of 20lb, 1.7$\pm$4.3 mm in partial injury group, 2.3$\pm$1.9 mm in reconstruction group were anterior displaced (P<0.05). Under loading of 15lb, 1.2$\pm$1.0 mm in partial injury group, 1.4$\pm$1.5 mm in reconstruction group were dis-placed (P<0.05). There were giving way, effusion, instability and anterior knee pain in complication. Giving way was the frequent complication in the partial injury group. Conclusions: Clinical results of both group were similar. Functional evaluation of Lysholm was good and status of Tegner activity was maintained to physical fitness activites (jogging, regular bik-ing) in both groups on average. The results of conservative treatment for the partial ACL injury (less than 50$\%$) was satisfactory and equivalent to that of reconstructive treatment for the total ACL injury.

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측두악관절 내장증의 외과적 치험례

  • Kim, Jae-Seung;Jeong, In-Won
    • The Journal of the Korean dental association
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    • v.24 no.2 s.201
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    • pp.183-189
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    • 1986
  • 우측 측두악관절에 동통과 연발음을 수반한 개구장애 및 저작장애를 호소하는 환자에 있어서 측두 악관절조영술을 하므로써 관절원판부의 천공과 관절원판의 전방전위의 악관절내장증으로 진단하였으며, 악관절원판부의 성형술과 측두악관절 결절의 절제술을 시행하였다. 수술후 8주부터 최대개구가 4.5cm이였으며 측두악관절의 원활한 운동으로 별 불편없이 저작 및 개구운동이 가능하게 되었다.

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Arthroscopic ACL Reconstruction - How can I do well with notchplasty -

  • 최남용
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.1
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    • pp.7-9
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    • 2003
  • 전방십자인대 재건술시 이식건의 과간 절흔에 대한 충돌을 예방하기 위하여 어느 절도의 절흔 성형을 시행 할 것인가에 대하여는 아직까지 논란이 있으며 수술시 절흔의 형태, 골극 형성 유무, 이식건의 크기 경골 터널의 위치를 고려하여 시행하여야 한다. 절흔 후방의 골 제거가 과도하게 시행 될 경우에는 대퇴골 부착부가 외측으로 전위되어 슬관절의 생역학적 변화를 가져올 수 있고, 주변 관절 연골의 조기 퇴행성 변화를 초래할 수 있으므로 세심한 주의를 기울여야 하며 절흔 성형은 가능한 한 최소화 하는 것이 출혈, 동통 및 부종 등의 술후 합병증을 줄일 수 있다.

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Arthroscopic Treatment of Displaced Tibial Spine Fracture in Children (소아에서의 전위된 경골극 골절의 관절경적 치료)

  • Choi, Nam-Yong;Cheong, Hyung-Kook;Koh, Hae-Seok;Han, Suk-Ku;Nah, Ki-Ho;Song, Hyun-Seok;Kim, Bae-Gyun
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.148-153
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    • 2005
  • 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.

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Widening of Bony Tunnel after ACL Reconstruction Using Hamstring Tendon with Ligament Anchor(LA) Screw (슬괵건 및 LA나사를 이용한 관절경적 전방 십자 인대 재건술 후 골터널의 확장)

  • Song Eun Kyoo;Yoon Taek Rim;Jung Jong Wook;Jeong Kwang Cheul
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.69-73
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    • 2001
  • Purpose : To evaluate the clinical results and widening of bony tunnel after anterior cruciate ligament(ACL) reconstruction using hamstring tendon with Ligament Anchor(LA) screw, which is newly designed fur fixation of graft into femur. Materials and Methods : Fifty eight patients who were followed up at least more than 2 years after ACL reconstruction with four strands of Hamstring tendon were included in this study. The graft was fixed with LA screw at femoral tunnel and with bioabsorbable interference screw at tibial tunnel. The average period of follow-up was 28 months. The clinical results such as physical examination and Lysholm knee score and radiological results. widening of bony tunnel and instrumented anterior laxity test with $Telos^{\circledR}$(Telos stress device; Austin & Associates, Inc., Polston, US) were evaluated. Results . The Lysholm knee score was 60.0 in average preoperatively and improved to 94.0 in average at follow up. On the Lachman test, there were mild(+) instability in 16 cases, moderate(++) in 24, severe(+++) in 18 preoperatively. 50 cases were converted to negative and 8 to mild instability at follow up. On instrumented anterior laxity test with $Telos^{\circledR}$, side to side difference in 20 lb was 12.9mm in average preoperatively, and was decreased to 3.1mm in average follow-up. The femoral tunnel was widened from 10.6mm postoperatively to 12.7mm$(21.1\%)$ at follow up on antero-posterior plane and from 10.7mm to 12.4mm$(16.5\%)$ on lateral plane. Tibial tunnels was also widened from 9.8mm to 11.8mm$(20.7\%)$ on antero-posterior plane and from 9.9mm to 11.7mm$(18.9\%)$ in lateral plane. Conclusion : ACL reconstruction with hamstring tendon and LA screw was one of the choice of grafts and fixatives in restoring knee stability and in improving clinical results with little complications such as excessive widening of bony tunnel.

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The Prospective Comparing Study of Autologous Hamstring Tendon grafts with Autologous Bone-Patella Tendon-Bone Grafts for Anterior Cruciate Ligament Reconstruction (자가 슬괵건과 자가 슬개골건골을 이용한 관절경적 전방십자인대 재건술의 전향적 비교)

  • Ahn, Gil-Yeong;Nam, Il-Hyun;Moon, Gi-Hyuk;Lee, Yeong-Hyeon;Kim, Ki-Choul;Kim, Jung-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.1
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    • pp.1-6
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    • 2011
  • Purpose: The purpose of this prospective study is to compare the results of arthroscopic reconstruction of ACL using autologous hamstring tendon (Group 1) and autologous bone patella tendon bone (Group 2). Materials and Methods: From Jan. 2004 to Dec. 2007, fifty patients were analyzed in this study. A single surgeon performed the ACL reconstruction with autologous hamstring tendon (25 patients) and autologous bone patella tendon bone (25 patients) alternatively each other. The mean follow up period of two groups was 38 months (range 25~58 months). We evaluated the result of Lachman test, Pivot shift test as a physical examination and Lysholm score, Tagner activity scale as patients' satisfaction and functional status and Telometer for anterior instability of each groups at the time of final follow up. Results: In final results, negative or mild positive findings on Lachman test were 24 out of 25 cases (equally) in each groups.) Twenty two cases in the Group 1 and 21 cases in the Group 2 were negative on Pivot shift test. Lysholm scores mark 94.6 points in group 1 and 92.3 points in group 2 at the final follow up and Tegner activity scales mark 8.5 points (Group 1) and 8.1 points (Group 2) at the time of last follow up and there were no differences between the two groups statistically. The numbers of patients who have less than 5 mm of anterior translation of tibia under telometer at 20 degrees of knee flexion are 24 cases in group 1 and 23 cases in group 2. Conclusion: The overall improvements of clinical scores (Lysholm scores and Tegner Activity scales) of the group 1 were a little bit superior to those of the group 2, but there were no significant statistical difference between two groups.

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