• Title/Summary/Keyword: Anterior dislocation

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Arthroscopic Treatment of Metallic Suture Anchor Failures after Bankart Repair (Bankart 수술 후 발생한 금속 봉합 나사못 합병증의 관절경적 치료)

  • Shin, Sang-Jin;Jung, Jae-Hoon;Kim, Sung-Jae;Yoo, Jae-Doo
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.1
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    • pp.70-76
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    • 2006
  • Purpose: This study presents 5 patients who had metallic anchor protrusion on glenoid after Bankart repair in anterior shoulder instability and reviewed the cause, clinical feature and arthroscopic removal technique. Method and Materials: 5 male with average age of 22 years (range 19 to 25 years) were included. 4 patients had arthroscopic Bankart repair and 1 patient had open repair for anterior shoulder instability. They had protruded metallic suture anchors on glenoid and the protruded suture anchors were removed arthroscopically using larger suture anchor empty inserter. Results: 4 patients had painful clicking sound with motion of abduction and external rotation and 1 patient showed shoulder instability. The ROM showed normal except mild degrees loss of external rotation. The position of protruded metallic anchor was 2, 3 and 5 O'clock in three patients and 4 O'clock in 2 patients. In 2 patients, the metallic suture anchor was malpositioned about 5mm off on the medial side from the anterior glenoid edge. All had Outerbrige classification Grade II-III chondral damage on humeral head and 1 patient showed glenoid cartilage destruction. None had shoulder instability after 2 years of follow-up. Constant score was 65 preoperatively and 89 postoperatively. ASES score was 67 preoperatively and 88 postoperatively. Conclusion: Symptoms of protruded suture anchor are not combined with instability. Most of symptoms were revealed from the rehabilitation period and confused with postoperative pain. Prompt diagnosis and early arthroscopic removal or impaction of protruded metallic suture anchor is recommended because of serious glenohumeral cartilage destruction. This is easy and simple and reproducible method to remove protruded metallic suture anchor arthroscopically.

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Results of Open Versus Arthroscopic Method in Recurrent Anterior Shoulder Instability (관혈적 방법과 관절경적 방법을 이용한 재발성 견관절 전방 불안정의 치료 결과)

  • Hahn Sung-Ho;Yang Bo-Kyu;Yi Seung-Rim;Chung Shun-Wook;Lee Dong-Ho;Oh Se-Jin;Lee Chul-Ho;Ha Kwon-Ick
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.2
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    • pp.154-158
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    • 2002
  • Purpose: To compare the results of open and arthroscopic method in recurrent anterior should erinstability. Materials and Methods: The 68 patients who have been taken the open or arthroscopic Bankartrepair for the period of Jan. 1995 to April. 2000. One group (23 patients) had elected an arthroscopic Bankart repair, the other group (45 patients) had chosen open stabilization. Patients were followed up12 to 63 months (ave. 34 months) after surgery. Results: We found 2 cases of subluxation out of open repair group, and then treated by conservative method. There were another 2 cases of dislocation and 2 cases of subluxation out of arthroscopicrepair group, and we have taken out 1 case of reoperation by open method. Using the functional scales by Rowe, the patients who have taken the open method posted at the average point of 87, while the arthroscopic method posted 85 points. Patients satisfaction points were 84.6 and 72.5 respectively. There were no criteria of statistically significant except stability and motion score. Conclusion: Open Bankart repair would be better in stability, and arthroscopic method in ROM gain. Proper patient selection based on physical examination and arthroscopic inspection to optimize the indications contributed to successful treatment.

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Clinical Assessment, Panoramic and MRI Findings and Cephalometric Characteristics of Patients with Condylar Resorption (과두흡수환자의 자기공명영상 사진 평가 및 악안면 골격형태에 대한 연구)

  • Jang, Heon-Su;Hur, Yun-Kyung;Kim, Kyun-Yo;Ko, Yu-Jeong;Chae, Jong-Moon;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.34 no.4
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    • pp.409-420
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    • 2009
  • The aim of this study was to investigate clinical assessment, panorama & MRI findings and cephalometric characteristics in 42 patients with condylar resorption, who visited in the Department of Oral Medicine Kyungpook National University Hospital at 2006. The results were as follows; 1. Clinical assessment 1) Female was 34 and male was 8, females were predominant. Distribution of age showed as follows; 10s was 14, 20s was 13, 30s was 7, 40s was 3, 50s was 4 and 60s was 1 patient. 10s and 20s were predominant. 2) Most of the patients had parafunctional habit. 2. Findings of panorama & MRI 1) Most of the patients had degree of Grade II condylar resorption by panorama taking. 2) Most of the patients had disc dislocation and belonged to the degree of stage IV by MRI taking. 3. Cephalometric Characteristics 1) SN, SAr and saddle angle in female patients were significantly smaller and SN in male patients showed only significantly smaller than normal group. 2) SNA showed no difference from the normal group in both patients. SNB was smaller and ANB was lager in female patients than normal group. 3) SN-GoMe and FMA increased in patients. 4) Total posterior facial height & ramus height were significantly smaller. 5) Mandibular body length did not show any significant difference.

Normal Variation and Incidence of Coincided Alignment on Lisfranc Joint on Normal Foot Radiography (정상 성인 족부 방사선 사진에서 족근 중족 관절 선열 형성 빈도 및 정상 변이)

  • Kang, Chung-Nam;Kim, Jong-Oh;Ko, Sang-Hoon
    • Journal of Korean Foot and Ankle Society
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    • v.1 no.1
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    • pp.43-50
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    • 1997
  • The tarsometatarsal joint complex is formed by articulation of the five metatarsal bases with the three cuneiform bones and the cuboid bone. Fracture-dislocation of tarsometatarsal area are difficult to recognize on standard radiographs. The exact diagnosis is occasionally delayed. As a result, improper treatment and late sequelae remains. We decided to make a study of patients with normal foot radiographs on 200 cases. Standard radiographic evaluation was used to study the normal variants of the foot and to evaluate the coincided alignment of the lisfranc joint. Accurate accessment on AP & lateral & $30^{\circ}$ oblique projection of radiographs are very adventageous & important, and next final outcome was detected. : 1. Coincided alignment below 1mm and unfolded lisfranc joint on AP projection was well visalized on 1st cuneiform-metatarsal lateral border and 2nd cuneiform-metatarsal medial border. 2. Coincided alignment below 1mm and unfolded lisfranc joint on oblique projection was well visualized on 2nd cuneiform-metatarsal lateral border and 3rd cuneiform-metatarsal medial border and 3rd cuneform-metatarsal lateral border. 3. More proximal location of 2nd lisfranc joint compared to another joint was 196 cases (98%). It is due to inceleration of 2nd metatarsal base between 3rd & 1st cuneiform. 4. 3rd lisfranc joint was volarward position compared to 2nd listranc on lateral projection at 191 cases (95.5%). It's due to anterior covexity of lisfranc joint. 5. Wide dorsal sided 2nd lisfranc is investigated at 189 cases (94.5%). Because of it. 2nd & 3rd lisfrances are mainly volar dislocated usually. 6. Notching on 5th metatarsal base is visible on 171 cases (85.5%). 7. 4th lisfranc joint had offset normally within $2\sim3mm$ at 98 cases (49%). 8. 5th Lisfranc joint had normally offset within $2\sim3mm$ at 99 cases (49.5%). 9. On lateral projection, slight dorsal location of cuneiform to metatarsal base is investigated at 82 cases (41%).

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Short-term of Reverse Total Shoulder Arthroplasty for the Treatment of Irreparable Massive Rotator Cuff Tear

  • Park, Jong-Hyuk;Wang, Seong-Il;Lee, Byung-Chang
    • Clinics in Shoulder and Elbow
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    • v.17 no.4
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    • pp.152-158
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    • 2014
  • Background: To investigate the effectiveness of reverse total shoulder arthroplasty (RTSA) in treating irreparable massive rotator cuff tears (RCTs). Methods: Twenty-nine patients who underwent RTSA for the treatment of irreparable massive RCTs and completed follow-up for at least 1 year were selected. Their mean age was 69.7 years (range, 59-80 years). The mean follow-up was 17.7 months (range, 12-42 months). The shoulder range of motion was measured preoperatively and at final follow-up. The functional result was evaluated using visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeon (ASES) score, and Korean Shoulder Society (KSS) score. Additionally, the shoulders were categorized into two groups depending on prior history of surgery and the clinical outcomes were analyzed between two groups. Results: Mean pain VAS improved, from $6.6{\pm}1.2$ to $2.7{\pm}0.9$ (p=0.001), and the mean functional VAS from $35.7{\pm}4.2$ to $73.3{\pm}5.4$ (p=0.006). The mean ASES score improved from $37.2{\pm}2.8$ to $75.0{\pm}3.8$ (p=0.012). The mean KSS improved from $36.5{\pm}7.2$ to $75.6{\pm}5.4$ (p=0.009), the mean forward elevation from $66.3{\pm}4.7$ to $135.6{\pm}8.4$ (p=0.0001), and the mean abduction from $45.2{\pm}4.2$ to $119.0{\pm}6.5o$ (p=0.0001). Internal rotation differed significantly from the first sacral to the third lumbar vertebrae (p=0.036). External rotation did not change significantly (p=0.076). There was also no statistically significant difference between groups (no previous operation versus none). Four complications occurred: one superficial infection, one with anterior dislocation, one acromial fracture, and one clavicle fracture. Conclusions: RTSA provides reliable pain relief and recovery of shoulder function in patients with massive irreparable RCTs in short-term follow-up.

Comparative Analysis : The Patterns of Temporomandibular Disorder among Adolescents (청소년 측두하악장애 환자의 임상적 연구)

  • Ok, Soo-Min;Kim, Chang-Yong;Jeong, Sung-Hee;Ahn, Yong-Woo;Ko, Myung-Yun
    • Journal of Oral Medicine and Pain
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    • v.37 no.1
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    • pp.47-59
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    • 2012
  • A retrospective study was conducted to determine the patterns of Temporomandibular Disorder(TMD) among adolescents (12-19 years) over last ten years. 174 patients who had visited the Oral medicine of Pusan National University Dental Hospital in 2000 and 491 patients in 2008 were found on chart review. The results obtained were as follows : 1. The number of adolescent patients was significantly increased in 2008 than in 2000, especially in male. 2. Bruxing, clenching, holding habits and bad sleep hygiene were highly increased more in 2008 than in 2000. 3. Osteoarthritis was significantly increased in 2008 than in 2000 and anterior disc dislocation without reduction was slightly increased. 4. The ratio of male to female adolescent patients with osteoarthritis was remarkably increased. Among the patients who had holding, bruxing, clenching habits, significantly increased osteoarthritis found to be common. This could imply holding, bruxing, clenching habits are prominently associated with increasing risk of developing osteoarthritis.

Skeletal Factors Related to Open Lock of the Temporomandibular Joint (측두하악관절의 개구성 과두걸림 환자의 골격적 특성에 관한 연구)

  • Nam, Ji-Na;Lee, Jeong-Yun
    • Journal of Oral Medicine and Pain
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    • v.38 no.3
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    • pp.267-274
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    • 2013
  • This study was performed to investigate the skeletal factors related to open lock of the temporomandibular joint(TMJ). We compared the skeletal measurements on the cephalogram and transcranial radiograph among 3 groups, open lock group consisting of consecutively filed 50 patients with at least one open lock episode within recent 1 year, temporomandibular disorder(TMD) group of 50 TMD patients without open lock diagnosed by Research Diagnostic Criteria for TMD (RDC/TMD) Axis I, and normal group of 50 patients without TMD or open lock. The patients of TMD and normal group were randomly selected in an age-and-gender-matched way with ones of open lock group. Open lock group showed smaller saddle angle than normal group on cephalograms and steeper inclination of the articular eminence than TMD and normal groups on transcranial radiographs. These results imply that the patients with the joint located more anterior and the articular eminence with steeper inclination might be riskier to TMJ open lock.

TRAUMATIC ROOT FRACTURE IN YOUNG PERMANENT TEETH : A CASE REPORT (미완성된 근첨을 가진 영구치 치근 파절의 치유에 관한 증례)

  • Kang, Sun-Hee;Kim, Dae-Eop;Lee, Kwang-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.4
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    • pp.576-580
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    • 2003
  • A 7-year-old male was refered to Department of Pediatric Dentistry, Wonkwang Dental Hospital for treatment of a traumatic injury to the teeth of the maxillary anterior region of the mouth. His right central incisor presented subluxation and root fracture, the left central incisor had suffered intrusive luxation and root fracture. The initial treatment involved reposition and fixation of the teeth with 0.5mm stainless steel wire and composite resin. The patient was submitted for clinical and radiographic fallow-up. After 4 years, radiographically the right central incisor seemed to be healed by hard tissue union and showed to be indistinct fracture line, intact lamina dura. The left central incisor radiographically was healed by interposition of bone and connective tissue and showed to be distinct horizontal fracture line separating the fragments, and pulp canal obliteration. In clinical examination, the teeth showed a normal response to elective pulp test, percussion and mobility test. Pulp survival after injuries appears to be dependent upon the type of luxation injury, age of patient, stage of root development and degree of dislocation. In this case, the two teeth with incomplete root formation were suffered different type of injury by trauma and has showed different healing aspect.

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The Clinical Applicability of Transoral Transpharyngeal Approach to the Craniovertebral Junction Lesions (두개 경추 이행부의 병소에 대한 경구적 접근법의 유용성)

  • Cho, Tae Goo;Park, Kwan;Cho, Yang-Sun;Baek, Chung-Hwan;Nam, Do Hyun;Kim, Jong Soo;Hong, Seung-Chyul;Shin, Hyung Jin;Eoh, Whan;Kim, Jong Hyun
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.379-388
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    • 2000
  • Objective : Although transoral transpharyngeal approach is a very useful method for the lesions of craniovertebral junction, it is not frequently used because of anatomical unfamilarity, risk of cerebrospinal fluid(CSF) leakage, and resultant postoperative meningitis. To evaluate the usefulness of transoral transpharyngeal approach for various lesions of craniovertebral junction, clinical characteristics and the results of this approach are investigated. Methods : Transoral transpharyngeal approaches were performed in eight cases between 1996 and 1999. Among them, there were three basilar invaginations due to congenital anomalies, two odontoid type I fractures, two atlantoaxial dislocations, and one pseudotumor. Surgical methods included five cases of anterior decompression and posterior fusion, two anterior approaches for decompression and one transoral approach for biopsy. Results : This procedure allowed immediate clinical improvement in all cases. In seven patients with preoperative motor deficit showed a progressive neurological improvement. The follow-up plain x-rays demonstrated successful bony fusion in all patients. Only one patient suffered from postoperative wound dehiscence, but she completely recovered after wound revision. There was no complication of postoperative CSF leakages. Conclusions : Transoral transpharyngeal approach for the ventral lesions of craniovertebral junction, can be used as a relatively simple and effective method.

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Early Failure of Cortical-Bone Screw Fixation in the Lumbar Spinal Stenosis (요추부 협착에서의 피질골 궤도 나사못 고정의 초기 실패 사례에 대한 고찰)

  • Kwon, Ji-Won;Kim, Jin-Gyu;Ha, Joong-Won;Moon, Seong-Hwan;Lee, Hwan-Mo;Park, Yung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.5
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    • pp.405-410
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    • 2020
  • Purpose: Pedicle screw insertion has been traditionally used as a surgical treatment for degenerative lumbar spine disease. As an alternative, the cortical-bone trajectory screw allows less invasive posterior lumbar fixation and excellent mechanical stability, as reported in several biomechanical studies. This study evaluated the clinical and radiological results of a case of early failure of cortical-bone screw fixation in posterior fixation and union after posterior decompression. Materials and Methods: This study examined 311 patients who underwent surgical treatment from 2013 to 2018 using cortical orbital screws as an alternative to traditional pedicle screw fixation for degenerative spinal stenosis and anterior spine dislocation of the lumbar spine. Early fixation failure after surgery was defined as fixation failure, such as loosening, pull-out, and breakage of the screw on computed tomography (CT) and radiographs at a follow-up of six months. Results: Early fixation failure occurred in 46 out of 311 cases (14.8%), screw loosening in 46 cases (14.8%), pull-out in 12 cases (3.9%), and breakage in four cases (1.3%). An analysis of the site where the fixation failure occurred revealed the following, L1 in seven cases (15.2%), L2 in three cases (6.5%), L3 in four cases (8.7%), L4 in four cases (8.7%), L5 in four cases (8.7%), and S1 in 24 cases (52.2%). Among the distal cortical bone screws, fixation failures such as loosening, pull-out, and breakage occurred mainly in the S1 screws. Conclusion: Cortical-bone trajectory screw fixation may be an alternative with comparable clinical outcomes or fewer complications compared to conventional pedicle screw fixation. On the other hand, in case with osteoporosis and no anterior support structure particularly at L5-S1 fusion sites were observed to have result of premature fixation failures such as relaxation, pull-out, and breakage.