• Title/Summary/Keyword: 주관절 구축

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The Open Surgical Treatment for Stiff Elbow (주관절 구축의 관혈적 치료)

  • Lee, Ji-Ho;Ra, In-Hoo;Jeon, In-Ho
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.293-298
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    • 2010
  • Purpose: Since an injured elbow joint can disturb the activity of daily life by limiting motion, especially if the motion is restricted over 40 degree of flexion contracture and under 105 degree of further flexion, it is imperative to select the best method and the timing of treatment of the elbow stiffness. Therefore this review will discuss open surgical techniques for stiff elbows based on the literature. Materials and Methods: It is important to take sufficient clinical examination of the patient, including history taking. And, a surgeon should select appropriate procedure after accurately understanding about the status and cause of the stiff elbow with radiographic methods. Surgical methods include arthroscopic release open release, distraction arthroplasty, total elbow replacement and there are four approachs in the open release - anterior approach, medial "over the top" approach, limited lateral approach: column procedure, posterior extensile approach-. Results and Conclusion: Although at present the arthroscopic technique is emphasized for the treatment of elbow stiffness, a surgeon should know conventional open techniques.

Arthroscopic Treatment of Stiff Elbow (주관절 강직의 관절경적 치료)

  • Moon, Young-Lae;Nam, Ki-Young
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.299-303
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    • 2010
  • Purpose: Management of the stiff elbow by arthroscopic procedure is an effective but technically demanding. Our purpose was to review the specific arthroscopic maneuver which can be useful for the stiff elbow. Materials and Methods: A stiff elbow that is refractory to conservative treatment can be treated surgically to remove soft tissue or bony blocks to motion. The olecranon or coronoid osteophyte and loose bodies have been removed arthroscopically with good results and rare complications. Results and Conclusion: For the successful arthroscopic management of elbow stiffness, it need to knowledge and skills for debride contracted tissue and preserve vital anatomic structure.

The Impingement of The Posterior Elbow in The Heavy Workers (중노동자에서 발생된 주관절 후방부의 충돌 병변)

  • Moon, Young-Lae;Lee, Chul-Gap;Kim, Dong-Hui;Lee, Young-Kwan
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.60-64
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    • 2005
  • Purpose: To describe the impingement of the osteophyte between the olecranon process and olecranon fossa and to understand the effect of removing the lesion on the elbow extension in heavy workers. Materials and Methods: Arthroscopy was performed to elbow of heavy industrial workers who complained painful limitation of elbow extension.6 patients(Teases) with average age of 43 year were selected. The average ROM showed flexion contracture of $17^{\circ}$ and further flexion of $87^{\circ}$. Results: In all cases, after the operation two months follow up, mean flexion contracture improved from $17^{\circ}\;to\;2^{\circ}$ with further flexion from$87^{\circ}\;to\;122^{\circ}$. After the operation 1 year follow up, the mean flexion contracture was $3^{\circ}$ and further flexion was $113^{\circ}$. Pain relief within acquired range of motion was achieved in all cases and there was no complication in this series. Conclusion: Selective removal of the impingement bony spur for treatment of flexion contracture in the patient with chronic cumulative trauma disorder patients appear to be effective method to control pain, recover joint movement and at] ow early rehabilitation.

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Neglected Elbow Dislocation Occurred 3 Years Ago: Open Reduction and Hinged External Fixation - A Case Report - (3년전이 경과된 진구성 주관절 탈구: 개방적 정복술과 경첩 외고정 장치 - 1예 보고 -)

  • Kim, Bo-Kun;Kim, Kyung-Cheon;Park, Jun-Yeong;Shin, Hyun-Dae
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.266-269
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    • 2010
  • Purpose: We report case of neglected elbow dislocation for three years. Material and method: A 45 years old female patient presented with neglected elbow dislocation for three years. Since the patient had contracture in both lateral and medial collateral ligament of elbow, dissection was done. After total separation of posterior articular capsule and incision of anterior articular capsule, by manual manipulation, reduction of radiohumeral and ulnohumeral joints were obtained. We applied modified Morrey type hinged external fixation in the elbow and done early elbow exercise. Result and Conclusion: Since we have experienced a satisfactory result in the case with neglected elbow dislocation for 3 years by using open reduction and hinged external fixation, we report it with the literature.

Pathophysiology of Stiff Elbow (주관절 강직의 병태 생리)

  • Song, Hyun-Seok;Yoon, Hyung-Moon
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.286-292
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    • 2010
  • Purpose: Stability of joints and maintenance of range of motion are needed for optimum function. The most common complaint about the elbow joint is joint stiffness. Recent articles have reported good outcomes in the treatment of stiff elbow joints. However, deciding which procedure to use is always difficult. Materials and Methods: Morrey et al. reported that the functional range of motion of the elbow joint is $30-130^{\circ}$ of flexion-extension and $50^{\circ}C$ of supination and pronation. About 90% of daily activities are done using this range of motion. Stiff elbow joints can be classified according to the traumatic events that caused the problem or the location of the main pathology. Intraarticular pathology includes severe articular mismatch, intraarticular adhesions, loss of articular cartilage, mechanical blockade by osteophytes, loose bodies, and hypertrophied synovium. Extraarticular pathology includes severe capsular adhesion due to the trauma or to dislocation, contracture of the collateral ligaments or muscles, bony bridge. Results and Conclusions: The main pathology underlying the loss of extension is the fibrous contracture of the anterior capsule. In this pathology, an anterior capsulectomy would be helpful. The main pathology underlying the loss of flexion is the contracture of the posterior band of medial collateral ligament.

Arthroscopic Treatment for Degenerative Elbow Contractures (주관절 퇴행성 강직의 관절경적 처치)

  • Moon, Young-Lae;You, Jae-Won;Kim, Dong-Whee
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.116-119
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    • 2001
  • Purpose : To describe long-term clinical results and serial changes in the postoperative range of motion(ROM) after arthroscopic treatment for a limitation of motion(LOM) of the elbow. Materials and Methods : The subjects who visited chosun university hospital from December, 1996 to January 2000 were twenty-one patients ranging from 37 to 54 years of age, and the average age was 43.2 years. The chief complaints were painful limitation of motion of the elbow and average ROM showed that flexion contracture were 17 degrees and further flexion were 87 degrees. Results : The total ROM was $70^{\circ}$ preoperatively. 2 months after postoperatively the mean flexion contracute improved from $17^{\circ}\;to\;3^{\circ}$ with further flexion from $87^{\circ}\;to\;122^{\circ}$ degrees. One year after postoperatively the mean flexion contracture were $5^{\circ}$ and further flexion were $113^{\circ}$. All patients reported a decresement in pain level as well as improvement in motion. There was no complication in this series. Conclusion : Arthroscopic surgery appear to be satisfactory management modality for degenerative elbow contractures.

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The Results of Ultrasound Examination of the Elbow in Middle School Baseball Players (중학교 야구선수에서 시행한 주관절 초음파 검사의 결과)

  • Hwang, Tae Hyok;Cho, Hyung Lae;Wang, Tae Hyun;Jin, Hong Ki
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.7 no.2
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    • pp.89-97
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    • 2014
  • Purpose: To evaluate the ultrasonographic findings of the elbows on group screening of middle school baseball players. Materials and Methods: Ninety-three players (age: 12-15, mean 13.5 years) of four middle school baseball team were evaluated with bilateral elbow ultrasonographies in the field regardless of elbow pain. Medial and anterolateral ultrasound examination of the both elbow were performed in the field to detect any abnormalities including medial epicondylar separation or fragmentation and capitellar osteochondritis dissecans respectively. We analyzed the relationship among elbow pain, physical findings and sonographic abnormalities and the differences of sonographic abnormalities between pitchers and fielders. Results: Thirty-six of 93 (39%) players had sonographic abnormalities of elbow in dominant arm, 30 with medial epicondylar apophyseal separation or fragmentation, 2 with osteochondritis dissecans, 4 with both lesions. Twenty-nine of 37 (78%) players with elbow pain had sonographic abnormalities. On physical examination, players with medial epicondylar abnormalities had medial epicondylar tenderness (59%) and pain on valgus stress test (52%), and 5 of 6 (83%) players with osteochondritis dissecans showed flexion contracture more than $5^{\circ}$. The incidence of medial epicondylar abnormalities between pitchers and fielders was statistically not significant but osteochondritis dissecans was more prevalent in pitchers (p<0.05). Conclusion: Elbow sonography is a simple and useful screening tool in the field and also effective for early detection of medial epicondylar abnormalities or osteochondritis dissecans that could be the main causes of elbow pain in adolescent baseball players.

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Synovial Chondroma Causing Radial Nerve Palsy (요골 신경 마비를 유발한 활액막 연골종)

  • Chun, Young-Soo;Kim, Joon-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.55-59
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    • 2007
  • Synovial chondroma is an uncommon benign lesion characterized by metaplastic cartilage formation within the synovial connective tissue, usually intraarticular, commonly affects the knee, hip and elbow. We would like to present the case of a 65-year-old man suffering from synovial chondroma of the right elbow responsible for radial nerve entrapment neuropathy. This is a case of synovial chondroma of the right elbow in an 65-year-old man presenting with pain and restricted joint movement of the right elbow, loss of extension and sensation of the right thumb and wrist. Plain radiographs showed narrowing of elbow joint space, bony spur on the edge of the joint, and radio-opaque sclerotic change of subchondral area. MRI revealed $16{\times}12$ mm sized round mass on the radial head, homogenous low signal on T1WI, heterogenous high and low signal on T2WI. The patient underwent marginal excision of the mass, compressing the radial nerve. Diagnosis was confirmed by histologic examination.

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Relationship of Trochlear Medial Facet Osteophyte to Elbow Flexion in Elbow Joint without Trauma History (외상력이 없는 주관절에서 활차 내측 골극과 주관절 굴곡 제한과의 관계)

  • Kim, Byung Sung;Park, SungYong;Park, Kang Hee;Song, Hyun Seok;Kim, Hyung Tae;Yoon, Hong Kee;Nho, Jae Hwi
    • Clinics in Shoulder and Elbow
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    • v.16 no.2
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    • pp.100-106
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    • 2013
  • Purpose: The purpose of this study is to evaluate the relationship between trochlear medial facet osteophyte (TMFO) and elbow flexion in the elbow joints without trauma history. Materials and Methods: Twenty five patients, who underwent computed tomography without elbow trauma history, were reviewed. Patients were checked for osteophyte or loose bodies in the coronoid and olecranon sides. The height and length of TMFO were measured. Results: The average elbow flexion contracture was $18.6^{\circ}$, and further flexion was $112.1^{\circ}$. The TMFO height and length was 2.2 mm and 4.7 mm, respectively. The average elbow further flexion was $105.1^{\circ}$ in the coronoid block group (n=14) and $119.1^{\circ}$ (p=0.011) in the coronoid free group (n=11). The relationship between further elbow flexion and TMFO was significant with a partial correlation coefficient of 0.687(p<0.000) in the TMFO length. Conclusion: Elbow joints with longer TMFO length decrease further flexion.