• Title/Summary/Keyword: Anterior dislocation

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Arthroscopic Treatment using Bioabsorbable Knotless Anchor for Anterior Instability of Shoulder (관절경하 생체흡수형 Knotless Anchor를 이용한 견관절 전방 불안정성의 치료)

  • Lee, Yong-Jae;Lee, Tong-Joo;Lim, Kwang-Yul;Kim, Myung-Ku
    • Journal of the Korean Arthroscopy Society
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    • v.8 no.2
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    • pp.103-108
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    • 2004
  • Purpose: This study reported the outcomes following the use of bioabsorbable knotless anchor in patients with anterior instability of shoulder. Methods: We studied fifteen cases with traumatic anterior shoulder instability underwent arthroscopic Bankart repair with bioabsorbable knotless suture anchor between January 2003 and June 2003. Among fifteen patients, fourteen were male and one was female, with a mean patient age of 24 years (range 16-42). The mean follow-up was 14 months (range 12-18 months). We compared with operation time of twenty cases of arthroscopic Bankart repair by the suture anchor technique between January 2002 and October 2002. Results: Neither recurrent dislocation nor subluxation was happened in postoperative follow-up. Mean score for functional evaluation by Rowe et al. was 89.4 and that for patient subjective satisfaction was 87,5. At last follow-up period, average shoulder range of motion for flexion and external rotation was 171$^{\circ}$ and 54$^{\circ}$ respectively. All patients were satisfied except three who had an apprehension at the follow up. During Bankart repair, it took an average of 25.5 minutes for one knot with the use of suture anchor technique whereas an average of 16.5 minutes for one knot with the use of bioabsorbable knotless anchor. Significantly, we saved operation time with the use of bioabsorbable knotless anchor (P<0.05).Conclusion: Repairing the Bankart lesion with the use of knotless anchor technique has the advantage of obtaining good capsular tensioning and saving operation time. And it is considered to be very successful in treating shoulder instability without recurrent dislocation or subluxation.

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Total Ankylosis by Heterotopic Ossification in an Adolescent Anterior Trans-olecranon Fracture Dislocation: A Case Report

  • Kim, Beom-Soo;Song, Kwang-Soon;Bae, Ki-Cheor;Lee, Si-Wook;Um, Sang-Hyun;Cho, Chul-Hyun
    • Clinics in Shoulder and Elbow
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    • v.22 no.3
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    • pp.154-158
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    • 2019
  • The incidence of heterotopic ossification in adolescents appears to be lower than in adults. There exist very few reports of heterotopic ossification with total bony ankylosis in child or adolescent populations. We describe a case of total bony ankylosis of the elbow secondary to heterotopic ossification, in a 14-year-old female. Total ankylosis of the elbow at 45 degrees of flexion was noted 6 months postsurgery, and complete surgical excision of the heterotopic mass was performed. After an additional one-time dose of radiation therapy and nonsteroidal anti-inflammatory drug medication, full range of motion was obtained without any recurrence or other complications, up to the last follow-up of 30 months.

Lateral Cephalometic Assessment in Patients with Condylar Resorption (과두흡수가 있는 환자의 측방 두부방사선 계측)

  • Hur, Yun-Kyung;Park, Hyo-Sang;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.337-346
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    • 2006
  • Aims: The present study investigated the relationship between condylar resorption and craniofacial skeleton types(especially vertical relationships), the differences of craniofacial skeleton types between with open bite group and without open bite group, and the associations of anterior disc dislocation with or without reduction to condylar resorption with MRI. Patients selection and methods: Clinical examination, magnetic resonance imaging (MRI), panorama, lateral transcranial and lateral cephalometric radiographs in 34 patients with condylar resorption were used to investigate this relationship. Results and Conclusions: Patients with the following specific facial morphologic characteristics appear to be most susceptible to condylar resorption: (1) females were predominant, (2) patients' age ranged from 12 to 50 years old with a strong predominance for 2nd and 3rd decades, (3) patients had high mandibular plane angle and high gonial angle, (4) patients had decreased vertical height of the ramus, (5) patients had generally significant antegonial notch, (6) patients had predominance of Class I occlusal relationship with or without open bite but mandible was retruded as mean ANB 5.54 degrees, (7) condylar resorption rarely occurs in lower mandibular plane angle facial types, (8) although no statistically significant difference was found, the open bite group had a tendency more hyperdivergent skeletal pattern than the non open bite group, and (9) imaging demonstrates from small resorbing condyles to idiopathic condylar resorption and TMJ articular disc dislocations. Thus, morphologic features of patients with vertical discrepancies may represent a risk factor for the development of condylar resorption.

Alternative Fixation Technique for Bony Bankart Lesion with Using Suture Anchor (봉합나사와 골터널을 이용한 골성 반카르트 병변의 고정)

  • Kim, Byung-Kook;Lee, Ho-Jae;Kim, Go-Tak;Dan, Jinmyoung
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.574-578
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    • 2019
  • For the treatment of a bony Bankart lesion accompanied by an acute traumatic shoulder dislocation, anatomical reduction and stable fixation of the bone fragment and glenohumeral ligament are essential to avoid chronic instability or degenerative changes. If the Bankart lesion has large bony pieces or comminuted fragments, it can be difficult to perform precise and secure fixation of the big intraarticular fragment to the fracture site because of the limited visualization of the arthroscopic procedure. In addition, in the case of the open procedure, it requires an extensive surgical dissection to access the fractured fragment, which may cause surgical approach-related morbidity, such as neurovascular complications, delayed subscapularis healing, and increased risk of stiffness. This paper describes an alternative open suture anchor technique for a large bony Bankart lesion, which was secured anatomically with squared knots after a shuttle relay through bony tunnels and adjacent soft tissue and labrum. This technique can achieve anatomical and firm fixation under direct vision, and reduce the number of surgery related morbidities.

Latarjet Operation for Anterior Shoulder Instability with Glenoid Bone Defect (관절와 골 결손을 동반한 견관절 전방 불안정증에 대한 Latarjet 술식)

  • Cho, Seung-Hyun;Cho, Nam-Su;Yi, Jin-Woong;Choi, Il-Hun;Kwack, Yoon-Ho;Rhee, Yong-Girl
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.189-198
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    • 2009
  • Purpose: We wanted to evaluate the clinical results of the Latarjet procedure for treating anterior shoulder instability combined with a glenoid bone defect. Materials and Methods: Between Oct. 2006 and May. 2007, fourteen patients underwent a Latarjet operation to treat their anterior shoulder instability combined with a glenoid bone defect. The mean follow-up period was 15 months (range: 12 to 19 months), and the average age at the time of surgery was 29.9-years-old (range: 19 to 44 years). There were 13 males and 1 female. Eight patients exhibited involvement of the right shoulder. The dominant arm was involved in 8 patients. Six patients had undergone a previous arthroscopic Bankart repair before their Latarjet operation and 2 patients had a history of seizure. Results: The average Rowe score improved from 51.8 to 80.2 with 9 excellent, 4 good, and 1 fair results. The average Korean shoulder score for instability improved from 61.6 to 82.1 postoperatively. The active forward flexion and external rotation at the side of the involved shoulder was an average of $8^{\circ}$ and $16^{\circ}$ less than that of the uninvolved shoulder. The muscle strength of the involved shoulder measured 78.7% in forward flexion and 82.5% in external rotation, as compared with that of the uninvolved shoulder. There was 1 case of dislocation, 1 transient subluxation, 2 fibrotic unions, 1 resorption of the transferred coracoid process, 1 intraoperative broken bone, 1 transient musculocutaneous nerve injury and 1 case of stiffness. Conclusion: The Latarjet procedure for treating anterior shoulder instability combined with a significant glenoid defect effectively restores function and stability through extending the articular arc at the expense of external rotation. We should be cautious to avoid or detect complications when performing coracoid transfer.

Arthroscopic Findings of Biceps pulley in Shoulder Pathology (견관절 병변과 관련된 이두박건 활차의 관절경적 소견)

  • Choi Chang-Hyuk;Kim Shin-Kun;Jang Woo-Chang;Lee Sung-Jin
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.136-141
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    • 2002
  • Purpose : The role of biceps pulley is stabilizing sling for the long head of the biceps tendon against anterior shearing stress in the rotator interval. The purpose of this study was to classify arthroscopic findings of biceps pulley and to evaluate the relationship with shoulder pathology. Materials and Methods : From January 2002 through July 2002, we observed biceps pulley in 49 cases of shoulder pathology treated with arthroscopically. There were 22 cases of anterior instability, 12 cases of rotator cuff tear, 5 of impingement syndrome, 6 of frozen shoulder, 2 of superior labral injury and 1 of each scapulothoracic bursitis and biceps dislocation. We classified biceps pulley as four types according to the arthroscopic appearance. Type I its stretched type. type II as sling type, type III at detached sling type, and type IV as concealed type. Results : We observed stretched type in 24 cases $(49\%)$, sling type in 5 cases $(10\%)$, detached sling type in 2 cases, concealed type in 1 case, and unidentified cases in 17 cases $(35\%)$. Conclusion : Development and variation of biceps pulley may have symptomatic correlation according to the degree of shoulder motion or pathologic status.

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SURGICAL EXTRACTION OF MULTIPLE SUPERNUMERARY TEETH BY TWO-STAGE PROCEDURE (상악 절치부에 매복된 다수 과잉치의 외과적 발거)

  • Hong, Eun-Hye;Kim, Seong-Oh;Lee, Jae-Ho;Choi, Hyung-Jun;Son, Heung-Kyu;Choi, Byung-Jai
    • Journal of the korean academy of Pediatric Dentistry
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    • v.35 no.2
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    • pp.333-338
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    • 2008
  • Supernumerary teeth are characterized by an excess number of teeth, which can be responsible for a variety of irregularities in the primary and transitional dentition. Supernumerary teeth, especially in the maxillary anterior region, may prevent the eruption of adjacent permanent teeth and cause their ectopic eruption, diastema, root resorption, or formation of dentigerous cyst. Therefore, early diagnosis of supernumerary teeth is important for prevention of such complications, and adequate treatment should be given according to their location, number, and morphologic features. In this case, four supernumerary teeth in the maxillary anterior region were disturbing the eruption of adjacent permanent incisors. Two of them were located in proximity to the central incisor tooth germs that their immediate removal may injure the permanent tooth germs. In order to minimize such complications, surgical extraction of the four supernumerary teeth was performed in two stages. At first, only two inverted conical supernumerary teeth were extracted. The other two tuberculous supernumerary teeth, close to the permanent tooth germs, were extracted later after their natural dislocation. In that way, we could minimize affects on the neighboring permanent tooth germs and also the amount of alveolar bone removed during surgery.

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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.

Clinical Study on Monteggia Fracture (Monteggia 골절의 임상적 고찰)

  • Seo, Jae-Sung
    • Journal of Yeungnam Medical Science
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    • v.4 no.2
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    • pp.131-138
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    • 1987
  • In 1814, Giovanni Battista Monteggia first described two cases of fracture of proximal third of ulna with a dislocation of radial head, and this combined injury is now known as the Monteggia fracture. Despite its rarity, the importance of early recognition of dislocated radial head and correct treatment bas been emphasized. Eight cases of Monteggia fracture were studied from March, 1984 to June, 1987. The results are as follows 1. Male patients were six and female were two. 2. The frequent cause of injury was fall down in four cases. 3. Bado type I accounted for 50%, type II for 12.5% and type III for 37.5%. 4. The level of ulna fracture was above upper one third of ulna in seven. 5. The common direction of dislocated radial head was anterior. 6. Two children and two adults were managed by closed reduction. Four ulna fractures in adult were treated by open reduction and internal fixation using a semitubular plate. 7. The results (by Bruce et al. criteria) were 3 excellent, 2 good, 1 fair and 2 poor.

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Total Ankle Arthroplasty for the Post-traumatic Osteoarthritis (외상후성 관절염에 대한 족관절 인공관절 전치환술)

  • Lee, Keun-Bae;Cho, Sang-Gwon;Kim, Byung-Soo;Choi, Min-Sun
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.45-50
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    • 2007
  • Purpose: To evaluate the short-term clinical outcomes of total ankle arthroplasty for the post-traumatic osteoarthritis. Materials and Methods: Fourteen patients who had undergone total ankle arthroplasty from February 2005 to June 2006 were reviewed. Eleven patients were male and three patients were female. The mean age was 52.8 years (range, 33 to 69 years). The mean follow-up duration was 15.9 months (range, 12 to 24 months). Primary injuries were pilon fractures in eight cases, malleolar fractures in three, ankle syndesmotic injury in one, talus fracture and dislocation in one, and distal tibial physeal injury in one. Visual analogue scale (VAS), Range of motion (ROM), American Orthopaedic Foot and Ankle Society (AOFAS) score and complications were evaluated. Results: The mean VAS improved from 8.6 preoperatively to 2.6 at last follow-up. The mean ROM improved from 24.6 degrees preoperatively to 33.1 degrees postoperatively. The mean AOFAS score improved from 44.5 points preoperatively to 75.1 points postoperatively. Radiographically, all components were stable, but there were component malpositions in two cases, including one varus malposition of tibial component and one increased anterior translation of talar component. Complications were deep infection in one case, intraoperative malleolar fracture in three, marginal wound necrosis in two, and heterotopic ossification in one. One prosthesis was revised because of deep infection. Conclusion: Total ankle arthroplasty for the post-traumatic osteoarthritis is believed to be an useful method for preservation of the motion, relief of the pain and high satisfaction of patients in short-term results.

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