• Title/Summary/Keyword: 충돌증후군

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Minimal Invasive Plate Osteosynthesis in Proximal Humerus Fractures (상완골 근위부 골절에서의 최소 침습적 금속판 술식)

  • Shin, Sang-Jin;Do, Nam-Hun;Song, Mi-Hyun;Sohn, Hoon-Sang
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.202-208
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    • 2010
  • Purpose: In this study we introduced minimal invasive plate osteosynthesis (MIPO) and analyzed clinical outcomes to determine the effectiveness of this intervention in proximal humerus fractures. Materials and Methods: We studied 27 patients including 16 cases with a 2-part fracture, 10 cases with a 3-part fracture, and 1 case with a 4-part fracture. Clinical outcomes were evaluated using UCLA score, KSS score and recovery of range of motion. Time to union and humerus neck-shaft angle change were estimated by radiologic assessment. The average follow up period was 19 months. Results: UCLA scores were "excellent" for 15 patients, "good" for 12 patients. The mean KSS score was 91.4 at final follow-up. The average shoulder range of motion was $167.2^{\circ}$ in forward elevation. Bone union occurred by 14.1 weeks postoperatively. Humerus neck-shaft angle recovery was "excellent" in 24 patients and "moderate" in 3 patients. There were no complications such as axillary nerve paralysis, deep infection, or subacromial impingement of the plate. Conclusion: MIPO for proximal humerus fractures is an effective procedure if performed with sufficient understanding of the anatomical structures. MIPO leads to minimized dissection of soft tissue, low complication rates and early recovery of range of motion.

Diagnostic efficacy of specialized MRI & clinical results of arthroscopic treatment in ankle soft tissue impingement syndrome (족근 관절 연부조직 충돌 증후군에서 MRI의 진단적 의의 및 관절경적 치료 결과)

  • Lee, Jin-Woo;Moon, Eun-Su;Kim, Sung-Jae;Hahn, Soo-Bong;Kang, Eung-Shick
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.208-217
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    • 2003
  • Introduction: Soft-tissue impingement syndrome is now increasingly recognized as a significant cause of the chronic ankle pain. As a method to detect soft-tissue ankle impingement, a characteristic history and physical examination, routine MR imaging, and direct MR arthrography were used. The efficacy of routine MR imaging has been controversial for usefulness because of low sensitivity and specificity. Direct MR artrhography was recommaned for diagnosis because of the highest sensitivity, specificity and accuracy, but it requires an invasive procedure. The purpose of this study is to investigate the diagnostic accuracy of Fat suppressed, contrast enhanced, three-dimensional fast gradient recalled acquisition in the steady state with rediofrequency spoiling magnetic resonance imaging(CE 3D-FSPGR MRI) and to evaluate the clinical outcome of the arthroscopic treatment in assessing soft-tissue impingement associated with trauma of the ankle. Materials and Methods: We reviewed 38 patients who had arthroscopic evaluations and preoperative magnetic resonance imaging studies(3D-FSPGR MRI) for post-traumatic chronic ankle pain between January 2000 and August 2002. Among them, 24 patients had osteochondral lesion, lateral instability, loose body, malunion of lateral malleoli, and peroneal tendon dislocation. The patient group consisted of 23 men and 15 women with the average age of 34 years(16-81 years). The mean time interval from the initial trauma to the operation was 15.5 months(3 to 40 months), The mean follow-up duration of the assessment was 15.6months(12-48 months). MRI was simultaneously reviewed by two radiologists blinded to the clinical diagnosis. The sensitivity, specificity and accuracy of MRI was obtained from radiologic and arthroscopic finding. Arthroscopic debridement and additional operation for associated disease were performed. We used a standard protocol to evaluate patients before the operation and at follow-up which includes American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score. Results: For the assessment of the synovitis and soft tissue impingement, fat suppressed CE 3D-FSPGR MR imaging had the sensitivity of 91.9%, the specificity of 84.4 and the accuracy of 87.5%. AOFAS Ankle-Hindfoot Score of preoperative state was 69.2, and the mean score of the last follow-up was 89.1. These were assessed as having 50% excellent(90-100) and 50% good(75-89). The presence of other associated disease didn't show the statistically significant difference(>0.05). Conclusion: Fat suppressed CE 3D-FSPGR MR imaging is useful method comparable to MR arthrography for diagnosis of synovitis or soft-tissue impingement, and arthroscopic debridement results in good clinical outcome.

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An Analysis of Swimming Injuries and Their Rehabilitation (근육 골격계의 질환 및 재활분석(수영선수를 중심으로))

  • Kim, Kwi-Baek;Ji, Jin-Gu;Kwak, Yi-Sub
    • Journal of Life Science
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    • v.32 no.4
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    • pp.325-330
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    • 2022
  • While swimming is a very popular competitive sports activity, swimming injuries are unique due to the repetitive nature of the swimming stroke and demanding training programs that can result in upper limb overuse. Therefore, the primary objective of this review was to analyze swimmers' injury areas, injury types by stroke type, and swimming rehabilitation, as well as to discuss safety management for improving swimming performance. In this study, the injuries incurred in swimming events were discussed in the order of upper limb injuries (neck, shoulder, arm, and wrist), lower limb injuries (knee and ankle), and waist injuries. An analysis by stroke type found that shoulder injuries occurred most often with freestyle, backstroke, and butterfly strokes, followed by rotator cuff injury, impingement syndrome, and SLAP (superior labral tear from anterior to posterior) lesions. Knee injuries were associated with the breaststroke, whereas spinal cord injuries occurred with the breaststroke and butterfly stroke. Finally, back injuries were associated with the butterfly stroke. During the freestyle stroke, the shoulder undergoes repetitive overhead movement; hence, shoulder and musculoskeletal pain are the most common and well-documented complaints of swimmers. For safety management, coaches and instructors must ensure that athletes do sufficient warm-up and cool-down exercises to avoid injuries. In case of an injury, they should be familiar with first aid measures so that secondary damage can be prevented with its quick application. In addition, coaches and instructors need to be trained in injury prevention and treatment so that they can provide appropriate rehabilitation treatment for athletes. Although swimming-related injuries cannot be completely eliminated, to reduce them to a minimum, leaders need the knowledge to apply scientific and systematic training principles and methods individualized for each athlete.

Investigation for Shoulder Kinematics Using Depth Sensor-Based Motion Analysis System (깊이 센서 기반 모션 분석 시스템을 사용한 어깨 운동학 조사)

  • Lee, Ingyu;Park, Jai Hyung;Son, Dong-Wook;Cho, Yongun;Ha, Sang Hoon;Kim, Eugene
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.1
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    • pp.68-75
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    • 2021
  • Purpose: The purpose of this study was to analyze the motion of the shoulder joint dynamically through a depth sensor-based motion analysis system for the normal group and patients group with shoulder disease and to report the results along with a review of the relevant literature. Materials and Methods: Seventy subjects participated in the study and were categorized as follows: 30 subjects in the normal group and 40 subjects in the group of patients with shoulder disease. The patients with shoulder disease were subdivided into the following four disease groups: adhesive capsulitis, impingement syndrome, rotator cuff tear, and cuff tear arthropathy. Repeating abduction and adduction three times, the angle over time was measured using a depth sensor-based motion analysis system. The maximum abduction angle (θmax), the maximum abduction angular velocity (ωmax), the maximum adduction angular velocity (ωmin), and the abduction/adduction time ratio (tabd/tadd) were calculated. The above parameters in the 30 subjects in the normal group and 40 subjects in the patients group were compared. In addition, the 30 subjects in the normal group and each subgroup (10 patients each) according to the four disease groups, giving a total of five groups, were compared. Results: Compared to the normal group, the maximum abduction angle (θmax), the maximum abduction angular velocity (ωmax), and the maximum adduction angular velocity (ωmin) were lower, and abduction/adduction time ratio (tabd/tadd) was higher in the patients with shoulder disease. A comparison of the subdivided disease groups revealed a lower maximum abduction angle (θmax) and the maximum abduction angular velocity (ωmax) in the adhesive capsulitis and cuff tear arthropathy groups than the normal group. In addition, the abduction/adduction time ratio (tabd/tadd) was higher in the adhesive capsulitis group, rotator cuff tear group, and cuff tear arthropathy group than in the normal group. Conclusion: Through an evaluation of the shoulder joint using the depth sensor-based motion analysis system, it was possible to measure the range of motion, and the dynamic motion parameter, such as angular velocity. These results show that accurate evaluations of the function of the shoulder joint and an in-depth understanding of shoulder diseases are possible.

Nitrogen Removal Rate of A Subsurface Flow Treatment Wetland System Constructed on Floodplain During Its Initial Operating Stage (하천고수부지 수질정화 여과습지의 초기운영단계 질소제거)

  • Yang, Hong-Mo
    • Korean Journal of Environmental Agriculture
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    • v.22 no.4
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    • pp.278-283
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    • 2003
  • This study was carried out to examine the nitrogen removal rate of a subsurface-flow treatment wetland system which was constructed on floodplain of the Kwangju River from May to June 2001. Its dimensions were 29m in length, 9m in width and 0.65m in depth. A bottom layer of 45cm in depth was filled with crushed granite with about $15{\sim}30\;mm$ in diameter and a middle layer of 10cm in depth had pea pebbles with about 10 mm in diameter. An upper layer of 5 cm in depth contained course sand. Reeds (Phragmites australis) were transplanted on the surface of the system. They were dug out of natural wetlands and stems were cut at about 40 cm height from their bottom ends. Water of the Kwangju River flowed into it via a pipe by gravity flow and its effluent was funneled back into the river. The height of reed stems was 44.2 cm in July 2001 and 75.3cm in September 2001. The number of stems was increased from $80\;stems/m^2$ in July 2001 to $136\;stems/m^2$ in September 2001. Volume and water quality of inflow and outflow were analyzed from July 2001 through December 2001. Inflow and outflow averaged 40.0 and $39.2\;m^3/day$, respectively. Hydraulic detention time was about 1.5 days. Average nitrogen uptake by reeds was $69.31\;N\;mg/m^2/day$. Removal rate of $NO_3-N$, $NH_3-N$, T-N averaged 195.58, 53.65, and $628.44\;mg/m^2/day$, respectively. Changes of $NO_3-N$ and $NH_3-N$ abatement rates were closely related to those of wetland temperatures. The lower removal rate of nitrogen species compared with that of subsurface-flow wetlands operating in North America could be attributed to the initial stage of the system and inclusion of two cold months into the six-month monitoring period. Increase of standing density of reeds within a few years will develop both root zones suitable for the nitrification of ammonia and surface layer substrates beneficial to the denitrification of nitrates into nitrogen gases, which may lead to increment in the nitrogen retention rate.