• Title/Summary/Keyword: Anterior dislocation

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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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A Study of the Hinge Axis Point (Hinge Axis Point에 관한 연구)

  • Jung, Kum-Tae
    • The Journal of Korean Academy of Prosthodontics
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    • v.22 no.1
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    • pp.72-78
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    • 1984
  • The notion that the axis of the shaft of the articulator must coincide the patient's mandibular transverse axis tells us the importance of locating the axis precisely. When using kinematic axis to transfer a cast to an articulator, the anatomic asymmetry of the contralateral points will result in certain distortion when the axis transferred to an articulator where the mechanical axis produces symmetry. In this study, after locating the true hinge axis point with Denar hinge axis locator, the discrepancies between true hinge axis point and arbitrary hinge axis point that was 13mm anterior from the posterior margin of center of trangus to the outer canthus of eye were measured. And the discrepancies between left and right true hinge axis point in the superoinferior and anteroposterior directions were measured. For this study, 20 dental students who have no missing teeth and no difficulties of mandibular movement were selected. Upper and lower cast of subjects were mounted on Denar Mark II articulator uisng Denar Slidematic face-bow and centric relation record for the measurement of discrepancies between left and right true hinge axis points. The results obtained as follows. 1. The mean distance from the arbitrary hinge axis point to the true hinge axis point was as follows. Right: horizontal distance; 1.99mm, vertical distance; 2.12mm, linear distance; 3.36 mm. Left: horizontal distance; 1.39mm, vertical distance; 2.06mm, linear distance; 2.09mm. Total: horizontal distance; 1.69mm, vertical distance; 2.09mm linear distance; 3.06 mm. 2. The 87.5% of true hinge axis points were within 5mm of the arbitrary hinge axis point. 3. The mean discrepancies between the right and left hinge axis point were 2.92mm in superoinferior direction and 4.74mm in anteroposterior direction. 4. When transferring the axis to the articulator, anatomic asymmetry between right: and left axis point produces in dislocation of cast on the articulator, and undesirable shift in esthetic tooth position will be resulted.

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Snapping Triceps Syndrome with Dislocation of the Ulnar Nerve - Usefulness of Dynamic Ultrasonography - (척골 신경 탈구와 동반된 발음성 삼두근 증후군 - 동적 초음파 검사의 유용성 -)

  • Jeong, Woong-Kyo;Park, Sang-Won;Song, Dong-Ik;Lee, Soon-Hyuck
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.1
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    • pp.27-30
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    • 2008
  • Snapping triceps syndrome is a rare condition in which a distal portion of triceps and ulnar nerve dislocate over the medial epicondyle as the elbow is flexed or extended from flexed position. Because it is frequently misdiagnosed as other elbow pathologies, accurate diagnosis is essential and imaging study is often needed to confirm the abnormal movement of ulnar nerve and triceps. Ultraonography is a convenient and effective method which is able to allow continual visualization of soft tissue movement compared to the other imaging modality including MRI. We reported one patient of snapping triceps syndrome who was diagnosed with the use of dynamic ultrasonography and treated with ulna nerve anterior transposition and repositioning of medial head of triceps. And we also provide the usefulness of musculoskeletal ultrasonography for the diagnosis of snapping triceps syndrome.

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A Morphologically Atypical Case of Atlantoaxial Rotatory Subluxation

  • Umebayashi, Daisuke;Hara, Masahito;Nishimura, Yusuke;Wakabayashi, Toshihiko
    • Journal of Korean Neurosurgical Society
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    • v.55 no.5
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    • pp.284-288
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    • 2014
  • A rare case of atlantoaxial rotatory subluxation occurred after pediatric cervical spine surgery performed to remove a dumbbell-shaped meningioma at the level of the C1/C2 vertebrae. This case is classified as a post-surgical atlantoaxial rotatory subluxation, but has a very rare morphology that has not previously been reported. Although there are several reports about post-surgical atlantoaxial rotatory subluxation, an important point of this case is that it might be directly related to the spinal cord surgery in C1/C2 level. On day 6 after surgery, the patient presented with the Cock Robin position, and a computed tomography scan revealed a normal type of atlantoaxial rotatory subluxation. Manual reduction was performed followed by external fixation with a neck collar. About 7 months after the first surgery, the subluxation became severe, irreducible, and assumed an atypical form where the anterior tubercle of C1 migrated to a cranial position, and the posterior tubercle of C1 and the occipital bone leaned in a caudal direction. The pathogenic process suggested deformity of the occipital condyle and bilateral C2 superior facets with atlantooccipital subluxation. A second operation for reduction and fixation was performed, and the subluxation was stabilized by posterior fixation. We encountered an unusual case of a refractory subluxation that was associated with an atypical deformity of the upper spine. The case was successfully managed by posterior fixation.

An Analysis of Stress Pattern in the Coracoclavicular Ligaments with Scapular Movements: A Cadaveric Study Using Finite Element Model

  • Kim, Yoon Sang;Kim, In-Sung;Yoo, Yon-Sik;Jang, Seong-Wook;Yang, Cheol-Jung
    • Clinics in Shoulder and Elbow
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    • v.18 no.3
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    • pp.152-158
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    • 2015
  • Background: Acromioclavicular (AC) stability is maintained through a complex combination of soft-tissue restraints that include coracoclavicular (CC), AC ligament and overlying muscles. Among these structures, the role of the CC ligament has continued to be studied because of its importance on shoulder kinematics, especially after AC injury. This study was designed to determine the geometric change of conoid and trapezoid ligaments and resulting stresses on these ligaments according to various scapular motions. Methods: The scapuloclavicular (SC) complex was isolated from a fresh-frozen cadaver by removing all soft tissues except the AC and CC ligaments. The anatomically aligned SC complex was then scanned with a high-resolution computed tomography scanner into 0.6- mm slices. The Finite element model of the SC complex was obtained and used for calculating the stress on different parts of the CC ligaments with simulated movements of the scapula. Results: Average stress on the conoid ligament during anterior tilt, internal rotation, and scapular protraction was higher, whereas the stress on the trapezoid ligament was more prominent during posterior tilt, external rotation, and retraction. Conclusions: We conclude that CC ligament plays an integral role in regulating horizontal SC motion as well as complex motions indicated by increased stress over the ligament with an incremental scapular position change. The conoid ligament is the key structure restraining scapular protraction that might occur in high-grade AC dislocation. Hence in CC ligament reconstructions involving only single bundle, every attempt must be made to reconstruct conoid part of CC ligament as anatomically as possible.

Arthroscopic Bankart Repair using Suture Anchors (봉합나사를 이용한 Bankart 병변의 관절경적 봉합술)

  • Kim, Kyung-Taek;Kim, Chul-Hong;Shin, Sang-Howa;Kwak, Jong-Ill
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.173-177
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    • 2006
  • Purpose: To evaluate the efficacy of arthroscopic Bankart repair using suture anchors for treatment of traumatic anterior instability of shoulder joint. Materials and Methods: We performed arthroscopic Bankart repair using suture anchor in 90 cases and evaluated the results with the functional grading system of Rows and Zarins after patients were followed up for more than 24 months. Results: Combined pathologies identified under arthroscopy were Hill-sachs lesion in 46 cases, SLAP lesion in 12 cases, Rotate cuff lesion in 7 cases. The results were excellent or good in 82(91.1%) cases and redislocation was happened only 3 cases. Conclusion: We concluded that arthroscopic Bankart repair with suture anchors is one of the reliable and effective method for recurrent shoulder dislocation with Bankart lesion.

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Ahmed Valve Implantation for Early Glaucoma Treatment in Dogs (개의 초기 원발성 녹내장안에서 Ahmed valve 이식술의 적용)

  • Park, Shin-Ae;Jeong, Man-Bok;Park, Young-Woo;Kim, Won-Tae;Kim, Se-Eun;Seo, Kang-Moon
    • Journal of Veterinary Clinics
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    • v.25 no.5
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    • pp.385-390
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    • 2008
  • The purpose of this study was to compare the long term prognosis of Ahmed valve implantation and medical therapy in dogs with early primary glaucoma. The medical records of dogs with early primary glaucoma from the Veterinary Medical Teaching Hospital of Seoul National University between January 2005 and May 2008 were reviewed. Five dogs underwent Ahmed valve implantation and medical therapy was performed in six dogs. Breeds of the dogs included Shih Tzu(n = 7), American cocker spaniel(n = 2), and miniature poodle(n = 2). Adequate intraocular pressure(IOP) was better maintained in the Ahmed valve implantation group than in the medical treatment group throughout the follow-up period. Mean time for vision loss to develop after treatment in the Ahmed valve implantation group($198.0{\pm}115.4$ days) was significantly longer than that in medical treatment group($43.2{\pm}30.4$ days, p < 0.05). Post-operative complications included occlusion of the tube by fibrin in the anterior chamber (n = 1), fibrous capsule about the episcleral base of the device(n = 1), and dislocation of the valve body(n = 1). It is considered that Ahmed valve implantation is more effective strategy to control IOP and maintain vision than medical treatment in early glaucomatous dogs.

Arthroscopic Bankart Repair with Suture Anchor (Bankart 병변의 봉합나사를 이용한 관절경적 봉합술)

  • Kim Kyung Taek;Kim Chul Hong;Kim Sung Hoo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.2
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    • pp.149-153
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    • 2002
  • Purpose: To evaluate the efficacy of arthroscopic Bankart repair using suture anchors for treatment of traumatic anterior instability of shoulder joint .Materials and Methods: We performed arthroscopic Bankart repair using suture anchor in 54cases and evaluated the results with the functional grading system of Rowe and Zarins after patients were followed up for more than 12 months. Results: Combined pathologies identified under arthroscopy were Hill-Sachs lesion in 28 cases, SLAP lesion in 6 cases and chondromalacia of humeral head in 6 cases. The results were excellent or good in 50 cases(92.6$\%$), and redislocation was happened only two cases. Conclusion: We conclude that arthroscopic Bankart repair with suture anchors is one of the reliableand effective method for treatment of recurrent shoulder dislocation with Bankart lesion.

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Ulnar Nerve Subluxation Diagnosed by Dynamic Ultrasonography (동적 초음파를 이용하여 진단한 주관절 척골 신경 아탈구)

  • Ji, Jong-Hun;Jung, Jae-Jung;Kim, Young-Yul;Kang, Hyun-Taek;Park, Sang-Eun;Kim, Dong-Jin
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.2
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    • pp.79-83
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    • 2010
  • Musculoskeletal ultrasonography has been used as a convenient and simple tool for diagnosis of various conditions of orthopaedic diseases for many years. Generally magnetic resonance imaging (MRI) is thought to be the best method to search for anatomical structures or variations. However, for dynamic conditions such as dislocation or subluxation of tendons and nerves, MRI is not superior to ultrasonography, especially dynamic ultrasonography. So we present such a patient with an ulnar nerve subluxation at the elbow who has symtoms mimicking cubital tunnel syndrome diagnosed by dynamic ultrasonography and treated successfully by ulnar nerve anterior transposition and think that dynamic ultrasonography is a useful method for diagnosing dynamic condition such as ulnar nerve subluxation mimicking cubital tunnel syndrome.

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Operative Treatement of Snapping Triceps Syndrome and Ulnar Nerve Dislocation (수술적으로 치료한 주관절 삼두근 탄발 증후군과 척골 신경 탈구 - 2예 보고 -)

  • Kang, Ho-Jung;Lee, Hee-Young;Lee, Jeong-Gil;Kim, Sung-Jae;Hahn, Soo-Bong
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.250-254
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    • 2009
  • Purpose: Snapping triceps syndrome is dynamic condition in which medial head of triceps snaps (dislocates) over the medial epicondyle as the elbow is flexed. Materials and Methods: The symptoms are pain or snapping at the medial aspect of the elbow and/or symptoms from coexisting ulnar nerve irritation. The diagnosis can be made by dynamic ultrasonography. Results and Conclusion: And successful outcome can be archived by operative treatment, which are ulnar nerve anterior transposition and tenotomy of medial head of triceps.