• Title/Summary/Keyword: 후방 관절

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Preoperative Shoulder MRI Findings to Predict Subscapularis Tendon Tear Requiring Surgical Repair (수술이 필요한 견갑하건 파열을 예측하기 위한 수술 전 어깨 MRI 소견)

  • Ji-hoon Jung;Young-Hoon Jo;Yeo Ju Kim;Seunghun Lee;JeongAh Ryu
    • Journal of the Korean Society of Radiology
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    • v.85 no.1
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    • pp.171-183
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    • 2024
  • Purpose This study aimed to investigate which indirect parameters on preoperative MRI were the principal predictors of subscapularis tendon tears (STTs) requiring surgical repair. Materials and Methods Preoperative MRI scans of 86 patients were retrospectively reviewed for visual assessment of the STT, pathology of the long head of the biceps tendon (LHBT), posterior decentering (PD) of the humeral head, humeral rotation, fatty degeneration, and subscapularis muscle atrophy. To evaluate atrophy, visual grading using the anatomical line connecting the coracoid tip to the glenoid base, designated as the base-to-tip line (BTL), and thickness measurements were performed in the en-face view. Results Arthroscopically, 31 patients (36%) exhibited Lafosse type III or IV STT and underwent surgical repair. LHBT pathology (p = 0.002), PD of the humeral head (p = 0.012), fatty degeneration (p < 0.001), and BTL grade (p = 0.003) significantly correlated with STT. In the multivariate analysis, PD of the humeral head (p = 0.011, odds ratio [OR] = 5.14) and fatty degeneration (p = 0.046, OR = 2.81) were independent predictors of STT. Conclusion PD of the humeral head and fatty degeneration of the subscapularis can help to diagnose clinically significant STT. Interpretation of these findings may contribute to the planning of an optimal surgical strategy.

Mini-open Rotator Cuff Repair Using Anterolateral Approach - Technical Note - (전외측 도달법을 이용한 소절개 회전근 개 봉합술 - 수술 술기 -)

  • Cho, Chul-Hyun;Sohn, Sung-Won;Bae, Ki-Cheor;Lee, Kyung-Jae;Seo, Hyuk-Joon
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.1
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    • pp.49-52
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    • 2010
  • Purpose: We introduce arthroscopically assisted mini-open rotator cuff repair using anterolateral approach. Operative Technique: Placing lateral decubitus position on general anesthesia, a standard arthroscopic glenohumeral examination is performed to evaluate lesions of shoulder joint through posterior and anterior portal. And then arthroscope is placed in the subacromial space and we evaluate the size of the torn tendon and perform arthroscopic acromioplasty through lateral portal. A 3 to 4 cm skin incision is performed from anterolateral edge of acromion to distal and dissected along to raphe between anterior and middle deltoid. A deltoid retractor is then placed, allowing direct visualization of the rotator cuff and humeral head. As torn tendon is tagged by traction suture, we try to anatomical reduction on the footprint and then perform single row or double row repair of the rotator cuff using suture anchors. To prevent avulsion of the deltoid from the acromion, additional sutures by bone tunnel with acromion and deltoid is performed. Conclusion: This technique is useful procedure to get direct approach to anterior portion of supraspinatus tendon and to need lesser deltoid retraction than portal extension approach due to dividing along to raphe between anterior and middle deltoid. Also it provide better visualization of the superior portion of subscapularis and infraspinatus.

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THE ANALYSIS OF THE POSITIONAL RELATIONSHIP OF CONDYLOID PROCESS WITH MANDIBULAR FOSSA AND MORPHOLOGICAL CLASSIFICATION OF CONDYLAR HEAD IN T.M.J. TROUBLE PATIENTS (악관절 기능장애 환자에 있어서 관절돌기의 위치적 관계 및 그 형태에 관한 방사선학적 연구)

  • Park Chang Sik
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.11 no.1
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    • pp.7-22
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    • 1981
  • A morphological and positional classification was undertaken in the transcranial and transorbital views of 174 traceable films which had been selected from those of 274 patients and previous tracing was performed. For the positional analysis, the author adopted the method which is not influenced by TMJ remodelling, and for the morphological classification, made progress the general method by adding indefinite type to four basic types. The aims of this sutudy consists in performing positional and morphological analysis of condylar head and in its morphological and positional variation in symptomatic patients. I want to express my sincere gratitude to Prof. Park, Tae Won in Seoul National University, interesting me in this field researches and for his never failing interests. I would lide to thank Prof. Ahn, Hyung Kyu and Prof. You, Dong Soo for helpful discussion and critical readings. The author is also indebted to Prof. Fuchihate Hajime in Osaka University, Prof. Uemura, Shusaburo and the late Dr. Nishihara, Heihachi for fruitful discussion and encourgements.

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The validity of transcranial radiography in diagnosis of internal derangement (악관절 내장증 평가 시 경두개 방사선사진의 임상적 유용성: MRI와의 비교연구)

  • Lee, In-Song;Ahn, Sug-Joon;Kim, Tae-Woo
    • The korean journal of orthodontics
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    • v.36 no.2 s.115
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    • pp.136-144
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    • 2006
  • The purpose of this study was to determine whether association exists between temporomandibular joint (TMJ) characteristics in transcranial radiographs and TMJ internal derangement and to evaluate the validity of transcranial radiographs in diagnosis of internal derangement. Transcranial radiographs and magnetic resonance imaging (MRI) of 113 TMJs from 76 subjects were used for this study and all TMJs were classified into 3 groups according to the results of MRI: normal disk position, disk displacement with reduction, and disk displacement without reduction. Transcranial analysis included linear measurement of joint spaces and condylar head angle measurement. To determine any relationship between transcranial measurements according to disk displacement, one-way ANOVA was used. The results showed that condyle-fossa relationship in standard transcranial radiographs had no relationships with disk displacement. And, as disk displacement progressed, condylar angle between head and neck increased significantly. This result can be interpreted that condylar head angle reflects structural hard tissue change according to internal derangement progress. But this is insufficient in the determination of internal derangement. Therefore, although still clinically helpful, the validity of standard transcranial radiographs to diagnose TMJ internal derangement was questioned.

Postoperative Deep Infection after Arthroscopic Knee Surgery (슬관절 관절경 수술 후 발생한 심부 감염)

  • Kim, Key-Yong;Ha, Dong-Jun;Shim, Hyung-Nam;Seo, Seung-Suk
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.1
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    • pp.20-23
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    • 2007
  • Purpose: The purpose of this study is to evaluate characteristics of a deep infection after arthroscopic knee surgery. Materials and Methods: We selected 894 patients who underwent arthroscopic knee surgery between February 1994 and August 2006. We analyzed the results of the patients with definite infection. Results: Seven cases out of the 894 knee arthroscopic surgery which was performed by one surgeon during 12 years were diagnosed as postoperative deep infection (0.9%). Infection developed in one repair case among the meniscal surgeries (1419=0.2%). There were six infection cases in intraarticular ligament reconstruction (6/343=2%); 3 in ACL surgeries (3/152), 2 in PCL surgeries (2/70) and 1 in combined cruciate ligament surgery and extra-articular reconstruction (l/26). Conclusion: Postoperative infection rate of arthroscopic knee surgery was relatively low. However an attention for the prevention of postoperative deep infection should be paid in intraarticular ligament reconstruction because of its relatively high risk of infection.

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Concomitant Fracture of Lateral Process and Posteromedial Tubercle of Talus (A Case Report) (거골의 외측 돌기와 후방 돌기 내측 결절의 동반 골절(1예 보고))

  • An, Ki-Young;Lee, Jun-Young;Yu, Jae-Cheul
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.233-235
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    • 2009
  • Concomitant fracture of medial tubercle of posterior process and lateral process of the talus has not been reported in Korean literature. Association between fracture of lateral and posterior process of talus is not clear. We treated with open reduction and screw fixation in fracture of lateral process and with excision of fragment of posteromedial tubercle of posterior process with satisfying result.

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The Role of Allograft for Posterior Cruciate Ligament Reconstruction (후방 십자 인대 재건술에서 동종 이식건의 역할)

  • Chun, Churl Hong
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.40-44
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    • 1998
  • The use of autogenous tissues is preferred for knee ligament reconstruction. However allografts play a role in major ligament reconstructive procedures in which multiple substitutions or revisions are required. In the dislocated knee, allografts may offer an advantage in reconstructing the PCL. But allografts in knee ligament surgery must be considered in terms of biomechanical and regenerative properties, disease transmission and immunogenecity, and methods of preservation and sterilization. Also only a few authors have described the use of allograft for reconstruction of a ruptured PCL, either a single procedure, or in combination with ACL repair following knee dislocation. Furthermore, the problems that the clinician faces with use of allografts is the necessity for supervision to ensure that the grafts are correctly processed, secondarily sterilized, and free of transmissible diseases. For these reasons, the routine use of allograft materials in the treatment of ligament deficiencies should be avoid and provide with meaningful outcome studies, including longterm follow-up.

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Anatomy and Biomechanics of the Posterior Cruciate Ligament (후방 십자 인대의 해부학과 생역학)

  • Kim, Hyoung-Soo
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.4-14
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    • 1998
  • As with anterior cruciate ligament reconstruction, posterior cruciate ligament(PCL) reconstruction requires a good understanding of the anatomy and biomechanical properties of the PCL to place the graft correctly as well as to choose the appropriate structure and material for the graft. The anatomy and function of the PCL can be somewhat confusing and continuing to evolve so far. Recent studies have focused on the insertion site anatomy and the identification of the functional components of the ligament. The issue of the ligament isometry and the role of PCL in knee kinematics are still totally resolved. This article can be provided an update on current concepts of the anatomy and biomechanics of the PCL through literature reviews. A clear understanding of these knowledges enables the clinicians to diagnose injuries to the PCL accurately and to reconstruct these structures successfully.

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Anomalous Insertion of Posterior Horn of Medial Meniscus - A Case Report - (내측 반월상 연골 후각의 비정상적 부착 - 1례 보고 -)

  • Min Byoung-Hyun;Ok Soon-Jong
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.1
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    • pp.45-48
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    • 2001
  • The anterior horn of the medial meniscus is attached to the anterior surface of the tibia. The anterior horns of the medial and lateral menisci are connect with the transverse ligament. The posterior horn of the medial meniscus is firmly attached to the posterior aspect of the tibia just anterior to the insertion of the posterior cruciate ligament. The authors incidentally found an anomalous insertion of posterior horn of medial meniscus into the anterior horn area during arthroscopic examination in the symptomatic knee joint, which had been ruptured anterior cruciate ligament, and report with literature review.

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