• Clinics in Shoulder and Elbow
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• v.9 no.2
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• pp.162-168
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• 2006

Purpose: To compare the clinical results of arthroscopic transglenoid suture with thermal capsulorrhaphy and thermal capsulorrhaphy on multidirectional shoulder instability. Materials and Methods: From January 1993 to September 2001, 23 patients who received the artrhoscopic treatment were the subjects and follow up period were at least 2 years. Each were subdivided as Group A(7 cases), which took transglenoid suture with thermal capulorrhaphy and Group B(16 cases), who took only thermal capsulorrhaphy. Clinical results were evaluated by Rowe score before and after surgery. Results: After operation according to Rowe score 4(57.1%) were excellent, 1(14.3%) were good and 2(28.6%) were fair in the Group A. for Group B 6(37.5%) were excellent, 2(12.5%) were good, 5(31.3%) were fair and 3(18.8%) were poor. Shoulder instability was recurred in 1(14.2%) case of Group A and 8(50%) cases of Group B during follow up period. Conclusion: Thermal capsulorrhaphy is thought to be a good adjuvent method, if it done with anterior capsular shift by transglenoid suture in multidirectional shoulder instability.

• Journal of Korean Neurosurgical Society
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• v.48 no.1
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• pp.37-45
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• 2010

Objective : Craniovertebral junction (CVJ) consists of the occipital bone that surrounds the foramen magnum, the atlas and the axis vertebrae. The mortality and morbidity is high for irreducible CVJ lesion with cervico-medullary compression. In a clinical retrospective study, the authors reviewed clinical and radiographic results of occipitocervical fusion using a various methods in 32 patients with CVJ instability. Methods : Thirty-two CVJ lesions (18 male and 14 female) were treated in our department for 12 years. Instability resulted from trauma (14 cases), rheumatoid arthritis (8 cases), assimilation of atlas (4 cases), tumor (2 cases), basilar invagination (2 cases) and miscellaneous (2 cases). Thirty-two patients were internally fixed with 7 anterior and posterior decompression with occipitocervical fusion, 15 posterior decompression and occipitocervical fusion with wire-rod, 5 C1-2 transarticular screw fixation, and 5 C1 lateral mass-C2 transpedicular screw. Outcome (mean follow-up period, 38 months) was based on clinical and radiographic review. The clinical outcome was assessed by Japanese Orthopedic Association (JOA) score. Results : Nine neurologically intact patients remained same after surgery. Among 23 patients with cervical myelopathy, clinical improvement was noted in 18 cases (78.3%). One patient died 2 months after the surgery because of pneumonia and sepsis. Fusion was achieved in 27 patients (93%) at last follow-up. No patient developed evidence of new, recurrent, or progressive instability. Conclusion : The authors conclude that early occipitocervical fusion to be recommended in case of reducible CVJ lesion and the appropriate decompression and occipitocervical fusion are recommended in case of irreducible craniovertebral junction lesion.

• Journal of Korean Foot and Ankle Society
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• v.14 no.1
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• pp.53-57
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• 2010

Purpose: This study was designed to evaluate the clinical and radiographical results of anatomical reconstruction by Chen method for chronic lateral ankle instability. Materials and Methods: Fifteen patients with chronic lateral ankle instability who had undergone anatomical reconstruction of anterior talofibular and calcaneofibular ligaments by Chen method were evaluated retrospectively. Average age of the patients was 31.3 years, and average follow-up period was 15.5 months. Preoperative and postoperative radiographs including varus stress view and magnetic resonance imaging (MRI) were analyzed. The clinical evaluation was performed according to the American Orthopaedic Foot and Ankle Society (AOFAS) scale. Results: Radiographically average talar tilt angle was $15.3^{\circ}$ preoperatively, and the difference with contralateral normal side was $10.1^{\circ}$. At last follow up, talar tile angle and the difference with contralateral side improved to $5.9^{\circ}$ and $1.3^{\circ}$ respectively. AOFAS scale was 66.6 preoperatively and 87.3 postoperatively. In MRI findings, four patients had associated intra-articular lesion such as articular cartilage defect, synovitis and osteoarthritis. The talar tilt angle improvement and AOFAS scale of patients without intra-articular lesion was better than those of four patients with intra-articular lesions. Surgical wound pain occurred in six patients and sural neuropathy in three patients. Conclusion: The anatomical reconstruction by Chen method was an easy and effective procedure for symptomatic chronic lateral ankle instability. Careful operative technique may prevent the surgical wound pain and sural neuropathy.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.3
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• pp.17-24
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• 2021

Background: The study aimed to examine changes in muscle activity by measuring the Q-angle and lower extremity activity when going down the stairs, after the application of either Mulligan taping or flossing bands to patients with chronic ankle instability. Methods: A total of 19 men with chronic ankle instability in their 20s and 30s participated in the study. Participants were randomly divided into two groups: the Mulligan taping group (n = 9) and the flossing band group (n=10). The Mulligan taping group had three sets of Mulligan joint operations repeated 10 times, after which the Mulligan tape was applied. The flossing band group either performed functional activities or exercised for 2 minutes after flossing band application. After the application of either Mulligan taping or flossing bands, changes in the Q-angle and lower limb muscular activity while going down the stairs were measured and compared. Results: In the Mulligan taping group, the Q-angle significantly decreased from 13.63° to 12.7° during the step down. Similarly, the Q-angle of the flossing band group significantly decreased from 15.95° to 15.48° (p<.05). There was no difference in lower limb muscle activity between the two groups when going down the stairs. The muscle activity of the tibialis anterior significantly increased from 34.12% to 40.2%, and the difference between the two groups were statistically significant (p<.05). Conclusions: The study found that the application of Mulligan taping and flossing bands to patients with chronic ankle instability decreased the Q-angle and lower limb muscle activity when going down the stairs.

• Clinics in Shoulder and Elbow
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• v.7 no.1
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• pp.1-4
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• 2004

As the multidirection and posterior instabilities of the shoulder are not only uncommon but responds well to conservative treatment, the shoulder instabilities which requires surgical treatment are traumatic anterior type in most cases, Although various surgical procedures had been used in the past, Bankart procedure is the standard surgical method as a primary procedure in traumatic anterior instability, Nevertheless there has been changes in the techniques of Bankart procedure in order to minimize decrease of external rotation and effectively address capsular laxilty, Capsular shift might be needed if there remains excessive capsular laxity of the inferior capsule after repair of the Bankart lesion, Large bony Bankart lesion should be fixed if possible and severe glenoid rim erosion requires extracapsular bone block after repair of the capsule. Although a few surgical procedures are described for the management of Hill-Sachs lesion in special circumstances, Hill-Sachs lesion does not usually need to be addressed.

• Journal of Korean Neurosurgical Society
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• v.51 no.3
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• pp.164-166
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• 2012

Penetrating injuries to the upper cervical spine resulting from gunshots are rare in South Korea due to restrictions of gun use. Moreover, gunshot wounds to the upper cervical spine without neurological deficits occur infrequently because of the anatomic location and surrounding essential structures. We present an uncommon case involving the surgical removal of a bullet located in the anterior arch of first cervical vertebra (C1) via a transoral approach without neurological complications or subsequent mechanical instability.

• Journal of the Ergonomics Society of Korea
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• v.23 no.4
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• pp.1-8
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• 2004

The objective of this study is to identify the effects of material position and physical fatigue on postural stability. Ten male subjects participated in this study. After bicycling exercises, their centers of pressure (COPs) were measured under four material handling positions and four excercise levels. The measured COPs were then utilized to calculate postural sway length in each experimental condition. Subjects' postural stability was quantified using the sway length. Results showed that the effect of different material handling position was significant on the postural sway length in both the posterior-anterior axis and the medio-lateral axis. Results also showed that the postural sway length was increased as physical fatigue accumulated, significantly in subject's posterior-anterior axis. The results imply that bearing a material on the back or front with both hands appeared to cause least sway length and instability.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.199-203
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• 1999

It is well known that the essential pathology in traumatic anterior dislocation of the shoulder is the avulsion of the glenohumeral ligament complex from the glenoid rim, However, there were some reports that the avulsion can occur from the humeral attachment site. We have experienced a 42-year-old man who had complained of persistent shoul­der pain after traffic accident and showed the instability on physical examination. The MR arthrogram and arthro­scopic surgery revealed the avulsion of glenohumeral ligament from the humeral attachment site. We repaired the lesion using the suture anchor through the anterior axillary approach and had a good result after 1 year.

• Journal of Trauma and Injury
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• v.32 no.1
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• pp.51-59
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• 2019

Unstable pelvic ring lesions are usually treated with internal fixation. In patients presenting clinical instability or soft tissue complication risk, external fixation is a safe treatment option. However, pin tract infection, insufficient biomechanical properties, difficulty sitting and changing decubitus are important drawbacks related to the treatment. The present study reports the association of anterior and posterior subcutaneous internal fixation by applying spine-designed implants on the pelvic ring disruption: supra-acetabular pedicle screws with an interconnecting rod (Infix), plus posterior transiliac fixation with the same system, which the authors have named the "Hula Hoop Technique".

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.290-294
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• 2023

Generally, patients with severe burst fractures, instability, or neurological deficits require surgical treatment. In most cases, circumferential reconstruction is performed. Surgical methods for three-column reconstruction include anterior, lateral, and posterior approaches. In cases involving an anterior or lateral approach, collaboration with general or thoracic surgeons may be necessary because the adjacent anatomical structures are unfamiliar to spinal surgeons. Risks include vascular or lumbar plexus injuries and cage displacement, and in most cases, additional posterior fusion surgery is required. However, the posterior approach is the most common and anatomically familiar approach for surgeons performing spinal surgery. We present a case in which three-column reconstruction was performed using only the posterior approach to treat a patient with a severe lumbar burst fracture.