• Title/Summary/Keyword: 후방 관절

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Intraoperative and Postoperative Complications After Arthroscopic Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft (자가 골-슬개건-골을 이용한 관절경적 전방십자인대 재건술의 수술 중 및 수술 후 합병증)

  • Kim, Kyung-Tae;Lee, Song;Jeong, Soon-Young;Kim, Hyun-Soo;Park, Jun-Seong
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.1-6
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    • 2002
  • Purpose : Evaluation and analysis of the incidence and causes of intraoperative and postoperative complications after arthoscopic anterior cruciate ligament(ACL) reconstruction using bone-patella. tendon-bone (BPTB) auto graft. Materials and Methods : We reviewed 85 cases of arthroscopic ACL reconstruction using BPTB autograft which had been followed up for more than 1 year. Intraoperative complications had been recorded and corrected during the operation. Postoperative complications were analyzed and compared between 3 groups which were classified by the last follow-up period after the operation. Results : There were a few intraoperative complications including patellar fracture(1 case), contamination of harvested graft(1 case), impingement of graft(2 cases), blow-out of tile posterior wall of the femoral tunnel(1 case) and intraarticular retraction of the screw(1 case). The result of the comparison of postoperative complications among the groups shows that the incidence of anterior knee pain, donor site pain and patellofemoral crepitation were significantly decreased after 2 years. But there was no significant decrease in these complications after 3 years. Conclusion : Intraoperative complications after arthroscopic ACL reconstruction using BPTB autograft were due to incorrect technique and carelessness of the operation team, and can be prevented by improvement of surgical technique and accumulation of experience. Postoperative complication were somewhat unavoidable but gradually improved with time; hence, we should consider it for the selection of graft donor.

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A Literature Review on Implant Assisted Removable Partial Denture (임플란트를 이용한 국소의치에 관한 문헌고찰)

  • Lee, Ji-Hye;Kim, Dae-Gon;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.28 no.2
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    • pp.179-190
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    • 2012
  • The installation of an implant in the distal extension area to assist a partial dentrue (IARPD) was used carefully in clinical situations. The purpose of this review on the IARPD is describing the concept, clinical results and guidelines of IARPD. For the review, a literature search was performed using the PubMed. The data from the literature suggest that the placement of the implants could improve function and patient satisfaction. In addition, IARPD reduced the residual ridge resorption. Longer and wider implant should be placed. Less than $15^{\circ}$ angulation may be not harmful. To prevent the loosening of the abutment, modified abutment or resilient attachment should be used. However, the connection method between the clasp retention and IARPD should be considered for long time success. Moreover, longitudinal clinical studies are required for evaluation of IARPD.

ACL Reconstruction with Remnant Preserving Technique - Technical Note - (잔류조직 보존 술기를 이용한 전방 십자 인대 재건술 - 수술 술기 -)

  • Cho, Sung-Do;Youm, Yoon-Seok;Jeong, Ji-Young;Jeon, Hyung-Min
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.82-85
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    • 2009
  • Purpose: In anterior cruciate ligament (ACL) reconstruction, preservation of the remnant original tissue might promote graft healing and be helpful in proprioception. But this procedure is difficult and causes the notch impingement. So we introduce a surgical technique that makes a transtibial femoral tunnel at 10 or 2 o'clock position with preservation of remnant tissue. Surgical approach: We tried to preserve the remnant tissue and synovium as much as possible, especially those of tibial attachment and extending to the posterior cruciate ligament (PCL), so as to have some tension and to prevent notch impingement. We set the tibial drill guide at 40~45 degrees and the intra-articular guide tip was 1 mm anterior and medial to the conventional site. The starting point of tibial guide pin was proximal to the pes anserinus and anterior to the medial collateral ligament. When the reamer approached the cortical bone of the tibial articular surface, the reamer must be advanced very carefully to minimize injury to the remnant tissue. The tibial and femoral tunnel at 10 or 2 o'clock position were made with the reamer, the diameter of which was same with that of the graft. Conclusion: We report a remnant preserving technique in ACL reconstruction that makes a transtibial femoral tunnel at 10 or 2 o'clock position

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Cephalometric Characteristics of the Patients with Developed Anterior Open Bite Following Anterior Disc Dislocation without Reductions (비정복성 관절원판 전위와 연관되어 발생된 전치부 개교합 환자의 측방 두부방사선 계측)

  • Hur, Yun-Kyung;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.31 no.3
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    • pp.255-263
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    • 2006
  • Objectives: This article reported three patients developed anterior open bite seemed to be related to TMJ anterior disc dislocation without reduction(ADD WO R), but no evidence of condylar destructive or collapse and analyzed the craniofacial skeletal structure by means of cephalometric analysis. Results: All patients suddenly developed a centric relation/centric occlusion discrepancy, an increased overjet and an anterior open bite following ADD WO R. All patients had Angle's Class I occlusion and shallow bite, but they had skeletally Class III and Class II pattern and all were vertically significant hyperdivergent type. Conclusions: These 3 patients had characteristics of common facial morphology including:(1)Angle classification Class I and shallow bite,(2)high mandibular plane angle,(3)high gonial angle. Developed anterior open bite resulted from clockwise rotation of the mandible related TMJ ADD WO R, rather than a result from the eruption of posterior teeth. We hypothesize rotation may relate to attached direction of masticatory muscle.

The Effect of the Combined Stretching and Strengthening Exercise on the Clinical Symptoms in Posterior Tibial Tendon Dysfunction Patient (후방 경골 건 기능부전 환자의 임상 증상에 운동 치료가 미치는 영향)

  • Jeong, Tae-Ho;Oh, Jae-Kun;Lee, Hong-Jae;Yang, Yoon-Joon;Nha, Kyung-Wook;Suh, Jin-Soo
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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    • pp.47-54
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    • 2008
  • Purpose: The isolated exercise therapy and its effect for the treatment of posterior tibial tendon dysfunction (PTTD) is not well known. The purpose of this study was to identify the clinical effect of stretching and strengthening exercise program on the patients' muscle function and range of motion, pain and gait in the management of the early stage PTTD. Materials and Methods: From October 2006 to March 2007, 14 patients with early stage PTTD (stage I or IIa) without surgical intervention were randomly assigned into two groups and we analyzed their clinical results. All patients were female and one who have sprained the same ankle during the program and one who withdrew from the program due to her private reason were excluded. At the last, the exercise group (EG) was seven and the control group (CG) was five. Mann-Whitney U test was used for the comparison of pain, ROM, muscle power, AOFAS score and 5 minute walking test of both groups. Wilcoxon-signed rank test was used for the comparison between the pre and post exercise program in EG. Results: The pain was significantly reduced in EG compare to CG and only the dorsiflexion was significantly increased in EG in the analysis of ROM. The dorsi flexion and plantar flexion power were significantly increased in EG. Conclusion: Our 6 weeks stretching and strengthening exercise program showed noticeably improved clinical result, and therefore it is recommended as one of the useful treatment option in the management of early stage PTTD.

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Management of the PCL Injuries (후방 십자 인대 손상의 치료)

  • Jung, Young Bok;Jung, Ho Joong
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.25-32
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    • 1998
  • The distinction between isolated and combined injuries is crucial both for treatment and prognosis. For most combined injuries, surgical treatment continues to be favored over nonoperative treatment. It is generally agreed that isolatel PCL injuries do well without surgery. There has been an interest by many authors to fix the graft directly to the posterior aspect of the tibia(tibial inlay). With this procedure, tibial graft fixation will be more direct and theoretically reduce the bending effects of the graft with a fixation site far away from the tibial insertion. Modified tibial inlay technique, which is the posterior approach does not require the patient to be in the prone or lateral decubitus position during the operation. Use of a double-bundle reconstructive technique is attractive and has been performed by some surgeons. At this time, this procedure is still being investigated and should not be routinely used in the clinical setting until studies have indicated an advantage over current single-bundle techniques. However theologically, double-bundle reconstructive technique is more useful in severe posterior unstable knee. Recent advances have increased our knowledge of the anatomy and mechanical characteristics of the PCL. Basic science research has further increased our awareness of the interaction of the posterolateral structures with the PCL. To achieve restoration of normal posterior laxity, it is critical to address the posterior as well as the postero-lateral structures. Surgical treatment is often complex and requires a wide range of surgical techniques and skills to treat associated injuries. When the PCL is reconstructed, most surgeons choose to reconstruct the anterolateral component using a graft of sufficient size and strength. The initial postoperative rehabilitation should be addressed cautiously in an effort to avoid excessive forces on delicate repairs and reconstructions in these complex injuries. Further research is necessary to evaluate new surgical approaches such as double-bundle reconstructions and tibial inlay techniques as well as improved techniques for capsular and collateral ligament injuries.

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Hindfoot Endoscopy for the Treatment of Posterior Ankle Impingement Syndrome: A Comparison of Two Methods (a Standard Method versus a Method Using a Protection Cannula) (후방 발목 충돌 증후군에서의 후족부 내시경 사용: 고식적 방법과 보호 도관을 이용한 방법의 비교)

  • Kim, Eung-Soo;Lee, Chang-Rak;Kim, Young-Jun;Roh, Sang-Myung;Park, Jae-Keun;Gwak, Heui-Chul;Jung, Sun-Gyu
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.1
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    • pp.26-31
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    • 2018
  • Purpose: The purpose of this study is to compare the clinical results between two different methods of hindfoot endoscopy to treat posterior ankle impingement syndrome. Materials and Methods: Between January 2008 and January 2014, 52 patients who underwent hindfoot endoscopy were retrospectively reviewed. Two methods of hindfoot endoscopy were used; Group A was treated according to van Dijk and colleagues' standard twoportal method, and group B was treated via the modified version of the above, using a protection cannula. For clinical comparison, the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, time required to return to activity, and the presence of complications were used. Results: There was no statistically significant difference in the AOFAS scores at the final follow-up, and there was also no statistically significant difference in the times for the scores to return to the preoperative level. There were no permanent neurovascular injuries and wound problems in either group. Conclusion: Use of protection cannula may provide additional safety during hindfoot endoscopy. We could not prove whether protection cannula can provide superior safety for possible neurovascular injury. Considering the possible safety and risk of using additional instrument, the use of this method may be optional.

Kinematical Analysis of Fastball and Longtoss during Baseball Throwing (투구시 속구와 멀리던지기 동작의 운동학적 비교분석)

  • Woo, Byung-Hoon;Jung, Yun-Jin
    • Korean Journal of Applied Biomechanics
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    • v.19 no.3
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    • pp.425-433
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    • 2009
  • The purpose of this study was to investigate relation between fastball motion and longtoss motion, and the kinematical analysis using APAS(Ariel Performance Analysis System). Eight people(age: $21.2{\pm}3.6years$, height: $177.1{\pm}3.1cm$, weight $68.6{\pm}2.5kg$) participated in the experiment. Followings are the conclusion. In displacement of fore-aft on COG(Center of Gravity), fastball motion moved more forward than longtoss motion. In displacement of vertical on COG(Center of Gravity), fastball motion was lower than longtoss motion In velocity of right hand, greater release velocity was measured for fastball motion than for longtoss motion. In displacement of elbow and shoulder joint, more extended displacement was exhibited in fastball motion than longtoss motion. In displacement of trunk tilt, fastball motion showed foreward tilt, longtoss motion showed backward tilt. In stride, fastball showed longer than longtoss.

The Pattern of Initial Displacement in Lingual Lever Arm Traction of 6 Maxillary Anterior Teeth According to Different Material Properties: 3-D FEA (유한요소모델에서 레버암을 이용한 상악 6전치 설측 견인 시 초기 이동 양상)

  • Choi, In-Ho;Cha, Kyung-Suk;Chung, Dong-Hwa
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.2
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    • pp.213-230
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    • 2008
  • The aim of this study was to analyze the initial movement and the stress distribution of each tooth and periodontal ligament during the lingual lever-arm retraction of 6 maxillary incisors using FEA. Two kinds of finite element models were produced: 2-properties model (simple model) and 24-properties model (multi model) according to the material property assignment. The subject was an adult male of 23 years old. The DICOM images through the CT of the patient were converted into the 3D image model of a skull using the Mimics (version 10.11, Materialise's interactive Medical Image Control System, Materialise, Belgium). After series of calculating, remeshing, exporting, importing process and volume mesh process was performed, FEA models were produced. FEA models are consisted of maxilla, maxillary central incisor, lateral incisor, canine, periodontal ligaments and lingual traction arm. The boundary conditions fixed the movements of posterior, sagittal and upper part of the model to the directions of X, Y, Z axis respectively. The model was set to be symmetrical to X axis. Through the center of resistance of maxilla complex, a retraction force of 200g was applied horizontally to the occlusal plane. Under this conditions, the initial movements and stress distributions were evaluated by 3D FEA. In the result, the amount of posterior movement was larger in the multi model than in the simple model as well as the amount of vertically rotation. The pattern of the posterior movement in the central incisors and lateral incisors was controlled tipping movement, and the amount was larger than in the canine. But the amount of root movement of the canine was larger than others. The incisor rotated downwardly and the canines upwardly around contact points of lateral incisor and canine in the both models. The values of stress are similar in the both simple and multi model.

Retromandibular Approach for the Open Reduction of Fractured Mnadibular Condyle (하악과두 골절의 관혈적 정복술을 위한 하악 후방 접근법)

  • Kim, Hak-Kyun;Kim, Su-Gwan;Kang, Dong-Wan;Oh, Sang-Ho
    • Journal of Dental Rehabilitation and Applied Science
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    • v.22 no.4
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    • pp.283-288
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    • 2006
  • There are several manners for surgical approaches to the mandibular condyle. With the retromandiular approach, the condyle and fracture are exposed directly and allow for good inspection and reduction. The retromandibular scar is very well camouflaged and practically invisible. The aim of this study was to evaluate clinical results of retromandibular approach for the reduction and fixation of fractured mandibular condyles. We described postoperative complications such as temporary facial nerve weakness involving the marginal mandibular branch, mouth opening limitation and malocclusion in 13 patients with mandubular condylar fractures; 11 subcondylar fractures and 2 condylar neck fractures. The follow-up period was longer than 6 months in all patients. The retromandibular approach was successful in all subcondylar fracture cases. 2 patients with condylar neck fracture had mouth opening limitation and temporary marginal nerve palsy longer than 3 months. But there were no cases of permanent nerve injury and malocclusion. Our findings indicate that retromandibular approach is an easy and safe technique for subcondylar fracture but not for condylar neck fracture.