• Journal of the Korean Arthroscopy Society
• /
• 제5권1호
• /
• pp.41-44
• /
• 2001

The muscular button holing of vastus medialis is a very rare case of irreducible knee dislocations, and rapid reduction of this can diminish the complications which delayed reduction accompanies. We diagnosed a patient who appeared posterolateral dislocation of the knee and protrusion of the medial femoral condyle with MRI grossly. That was reduced by open arthrotomy, followed the reconstruction of both cruciate ligaments and repair of medial collateral ligament. Patient didn't show joint instability except minor posterior sagging and had full range of motion postoperatively after 10 months.

• Journal of Veterinary Clinics
• /
• 제29권3호
• /
• pp.259-262
• /
• 2012

A seven-year-old Yorkshire terrier 2.1 kg was admitted with a 2 months history of sever bilateral forelimb lameness and joint instability. Examination and radiographs revealed caudal luxation of bilateral antebrachiocarpal joint. Luxation of bilateral antebrachiocarpal (ABC) joint in a toy breed dog was treated with pancarpal arthrodesis. Modified external skeletal fixator (ESF) (type IIb) with polymethylmethacrylate (PMMA) was utilized in this case. Porcine cancellous bone graft (PCBG) was inserted to fill the joint space in carpus. The clinical and radiographic assessments of joint after the surgical procedure proved that PCBG can be used a promising alternative to Autogenous cancellous bone graft (ACBG).

• Journal of Korean Orthopaedic Sports Medicine
• /
• 제12권1호
• /
• pp.16-23
• /
• 2013

Multiple ligament knee injury is defined as rupture to at least two of the four major knee ligament structures. Three or four knee ligament injury results in knee dislocation as complete disruption of the integrity of the tibiofemoral articulation. In multiple ligament knee injury, vascular and neurologic assessment should be performed meticulously and systematically. Emergency surgery should be needed if arterial injury is suspected. Surgical treatment rather than conservative management should be done and early surgery might be better than delayed surgery. Reconstruction of ACL and PCL, repair or reconstruction of MCL, and reconstruction of posterolateral corner are recommended, although many debates have occurred. Multiple ligament knee injury requires more aggressive management than single ligament knee injury.

• Journal of the Korean Orthopaedic Association
• /
• 제55권1호
• /
• pp.46-53
• /
• 2020

Purpose: Scapular body fractures have generally been treated with non-surgical methods. This study reports the clinical and radiological outcomes after lateral-posterior internal fixation for treating displaced scapular body fractures. Materials and Methods: From March 2007 to May 2017, out of 40 patients who underwent internal fixation for scapular fractures, 13 cases of lateral plate fixation of a scapular body fracture were reviewed retrospectively. Preoperative and postoperative displacement, angulation and glenopolar angle (GPA) were measured. The range of shoulder motion, visual analogue scale (VAS), and disabilities of the arm, shoulder, and hand (DASH), and Constant score were assessed at the last follow-up. Results: The mean follow-up period was 17.7 months (range, 6-45 months). The mean preoperative GPA was 23.3°±3.96° (range, 17.8°-28.1°) and the postoperative GPA was 31.1°±4.75° (range, 22.5°-40.1°). Injury to the suprascapular nerve, nonunion, fracture redisplacement, metallic failure, or infection did not occur. At the last follow-up, the mean range of motion was 150.5°±19.3° in forward flexion, 146.6°±2.34° in lateral abduction, 66.6°±19.1° in external rotation, and 61.6°±18.9° in internal rotation. The VAS, DASH, and Constant scores were 1.7±1.3, 6.2±2.4, and 86±7.9 points, respectively. Conclusion: A scapular body fracture with severe displacement, angulation and marked decreased GPA can be stabilized by lateralposterior plate fixation using the appropriate surgical technique with good functional and radiological results.

• Journal of Dental Rehabilitation and Applied Science
• /
• 제26권2호
• /
• pp.111-120
• /
• 2010

Purpose: This investigation was designed to evaluate the condyle position and the symmetry of the both condyle heads at the maximum intercuspal position on the sagittal CT image of the temporomandibular joint. Materials and Methods: Cone-beam CT was used to assess 400 joints in 100 symptom and 100 symtom-free subject(100 male, 100 female). Three independent observers(dentists) determined the positions classified with Anterior Position(AP), Middle Position(MP), and Posterior Position(PP), and the symmetry of the both condyle. Results: According to gender, the mean percentages of AP, MP, and PP were 48.5, 28.5, and 23 in male group, and 34, 38, and 28 in female group. The symmetry of condylar heads was more common than asymmetry in the both of groups. In the respect of symptom or symptom-free, the mean percentages of AP, MP, and PP were 44.5, 34, and 21.5 in the symptom-free group, and 37, 33.5, and 29.5 in the symptom group. The symmetry of condylar heads was more common in the symptom-free group, but the asymmetry of condylar heads was more common in the symptom group. Conclusions: These data might serve as useful criteria for the clinical assessment of condyle position at the maximum intercuspal position optained by Cone-beam CT.

• The Journal of Korean Orthopaedic Ultrasound Society
• /
• 제7권1호
• /
• pp.39-44
• /
• 2014

The patellar clunk syndrome is one of the patellofemoral complication, caused by formation of the fibrous nodule at the suprapatellar region after total knee arthroplasty. The symptom involves painful catching, crepitus and clunk during knee extension. It has been mainly but not exclusively associated with the posterior stabilized total knee system. The fibrous nodule is entrapped in the femoral intercondylar notch of the femoral component during flexion and as the knee is extended, it displaces back to the trochlear groove abruptly and the typical symptoms occur. The risk of developing this complication is primarily related to the design of the femoral component and higher incidence was noted with earlier designs of posterior stabilized knee prosthesis. Modifications have been made to the femoral component to optimize the kinematics of the patellofemoral joint and thereby reduced the incidence of patellar clunk syndrome but did not eliminate the problem completely. Clinical examination is the gold standard of diagnosis and imaging study has been used as a possible adjunct to diagnosis. Especially ultrasonography is an imaging modality, which can be easily performed to detect the fibrous nodule on the quadriceps tendon. We report a case of patellar clunk syndrome which was diagnosed with ultrasonography.

• Journal of the Korean Orthopaedic Association
• /
• 제54권5호
• /
• pp.418-426
• /
• 2019

Purpose: This study analyzed the features of humeral head decentralization in large to massive rotator cuff tears with a shoulder dislocation in the elderly. Moreover, shoulder instability and treatment were reviewed. Materials and Methods: From May 2005 to February 2017, Group A containing 45 cases (45 patients) over 65 years old accompanied by a large or massive rotator cuff tear with a shoulder dislocation and Group B containing 45 cases (45 patients) without a shoulder dislocation were enrolled. The mean ages in Groups A and B were 73.2 and 72.1 years old, and the mean follow-up periods were 30.7 and 31.3 months, respectively. Twenty-one cases (46.7%) in Group A underwent rotator cuff repair, and 8 cases (17.8%) underwent concomitant rotator cuff repair with Bankart repair. Sixteen cases (35.6%) underwent reverse total shoulder arthroplasty for cuff tear arthropathy. 45 cases (100%) in Group B underwent rotator cuff repair. The off-the center and head elevation were measured in the preoperative magnetic resonance imaging (MRI) of Groups A and B. The preoperative and postoperative visual analogue scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, and University of California Los Angeles (UCLA) score in Groups A and B were compared. Results: In Groups A and B, the mean off-the centers were posterior 7.41 mm and posterior 2.02 mm (p=0.03), and the mean head elevations were superior 6.66 mm and superior 2.44 mm (p=0.02), respectively. The mean ASES scores of Groups A and B were 32.8 and 33.4 before surgery, and 77.1 (p=0.02) and 78.1 (p=0.02) after surgery (p=0.18), respectively. The mean UCLA scores of Groups A and B were 13.1 and 12.8 before surgery, and 28.9 (p=0.02) and 29.5 (p=0.01) after surgery (p=0.15), respectively. Conclusion: Patients over 65 years old with a shoulder dislocation in large to massive rotator cuff tears had higher off-the center and head elevation on the preoperative MRI than those without a shoulder dislocation. This measurement can help predict preceding shoulder instability. Early rotator cuff repairs should be performed and other treatments, such as Bankart repair and reverse total shoulder arthroplasty, should also be considered.

• Journal of the Korean Arthroscopy Society
• /
• 제17권1호
• /
• pp.95-99
• /
• 2013

We introduce arthroscopic Bankart repair technique using antegrade suture passer that can effectively restore detached anteroinferior capsulolabral complex for shoulder anterior instability. After diagnostic arthroscopy is performed using posterior, anteroinferior and anterosuperior portals, we confirm Bankart lesion and perform debridement and decortications of anteroinferior glenoid edge and neck. Suture anchor is inserted through anteroinferior portal at 2 mm medial side of glenoid edge (4:30 direction). Scorpion$^{TM}$ loaded suture is directly advanced to detached and retracted anteroinferior capsulolabral complex and the suture is passed at 10~15 mm medial side of detached anteroinferior capsulolabral complex (5:30 direction). The suture is retrieved by Scorpion's hook and then is tied using samsung medical center (SMC) sliding knot technique. Then suture anchors are serially inserted (2:30, 3:30) and capsulolabral complex repair is performed using suture hook and suttle-relay technique. This technique that can obtain anatomical restoration of anteroinferior glenohumeral ligament with proper tension is useful technique to reduce postoperative recurrence and makes it possible for less experienced surgeons.

• Journal of Korean Orthopaedic Sports Medicine
• /
• 제6권2호
• /
• pp.126-129
• /
• 2007

An irreducible dislocation of the knee joint is quite rare. Most irreducible knee dislocations are posterolateral dislocations and result from the soft tissue interposition. To the best of our knowledge, there is no report of an irreducible knee dislocation result from interposition of the detached cartilage from the medial femoral condyle. We present a case of 51 years old female with irreducible knee dislocation which was treated with an arthroscopic debridement of the detached cartilage, result in reduction of the joint, which is failed in closed reduction. And then we perform the delayed arthroscopic reconstructions for the ruptured anterior and posterior cruciate ligaments. Debridement of the interposed structure using the arthroscope allows for reduction of the joint and good result without the need for an open procedure.

• The Journal of the Korean bone and joint tumor society
• /
• 제8권3호
• /
• pp.76-82
• /
• 2002

Purpose: Benign bone tumor of the talar body have rarely been evaluated according to the therapeutic methods because of the scarcity of their incidence. Here, we report our experience of 8 cases who were treated by using of posterior approach and curettage through the posterior process of the talus. Materials and Methods: Between February 1986 and October 2001, we experienced 8 cases of benign bone tumor occurring in the talar body. They included two osteoid osteomas, two giant cell tumors, one capillary hemangioma, one chondroblastoma, one simple bone cyst, and one osteochondroma. Their mean age was 22.1 years (ranging from 10 to 41 years). Mean follow-up period was 7.7 years (ranging from 1 to 16 years). All patients were treated by using of posterior approach. Two osteoid osteomas and one osteochondroma were treated by excision of tumors. Other cases were treated with curettage through the cortical window on the posterior process of the talus. Results: There was no recurrence during the follow-up period. one infection occurred. Except this case, all patients had no pain in weight-bearing, and complete range of movement at the ankle joint was reserved in each case. Conclusion: In this study, we suppose that posterior approach to the talar body may be a safe method with minimal damage of normal tissues and sufficient of curettage is capable through the cortical window on the posterior process of the talus.