• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.27-29
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• 2009

견관절 전방 불안정성에서 관절와 및 상완골 결손이 동반된 경우 적절한 진단과 치료는 치료 결과에 직접적인 영향을 주므로 중요하다. 견관절 불안정성은 정적 및 동적 안정화 구조물의 손상으로 기인하며, 상완골 두감입 골절(Hill-Sachs 병변), 관절와 골절이나 전하방 관절와 가장자리의 소실 등 정상적인 관절의 해부학 구조물을 훼손시키는 골성 이상 소견이 동반되면 경우에 따라 견관절 불안정성에 영향을 끼칠 수 있다. 본 강좌에서는 견관절 전방 불안정성에서 동반된 관절와 및 상완골의 골 결손에 대하여 논하고자 한다.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2001.03a
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• pp.62-63
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• 2001

• Journal of Korean Neurosurgical Society
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• v.29 no.11
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• pp.1461-1468
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• 2000

Objective : The aim of this study is to evaluate clinical outcome of anterior screw fixation for type II odontoid fractures for the prliematim of atlanatoaxial mobility. Methods : Between 1995 and 1999, we treated 15 cases of type II odontoid fractures by anterior screw fixation among 44 cases of odontoid fractures. Thece included 14 males and 1 female aged from 23 to 63 years, with a mean age of 39.7 years. The causes of trauma were traffic accident in 13 cases, slip down in 1 and fall down in 1. The fracture type was type II-P in 7 cases, type II-A in 3, type II-N in 2 and type II-A and P in 3. The fracture line was oblique downward and backward in 6 cases, oblique downward and forward in 3 and horizontally in 6. The range of follow up was 4 to 47 months(mean 26.5 months). Results : Adequate reduction and fixation were obtained in 12 cases. Three cases in which fracture type and line were type II-A and oblique downward forward were failed, so posterior transarticular screw fixation was performed. All except 3 failed cases had adequate cervical movement and stability. There were no operative mortality nor morbidity. Conclusion : Anterior screw fixation provides the best anatomical and functional results for type II odontoid fracture with intact transverse ligament when fracture line is horizontal or oblique downward and backward. But it is limited when fracture line is oblique downward and forward.

• Journal of Korean Neurosurgical Society
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• v.56 no.2
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• pp.114-120
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• 2014

Objective : At present, gold-standard technique of cervical cord decompression is surgical decompression and fusion. But, many complications related cervical fusion have been reported. We adopted an extended anterior cervical foraminotomy (EACF) technique to decompress the anterolateral portion of cervical cord and report clinical results and effectiveness of this procedure. Methods : Fifty-three patients were operated consecutively using EACF from 2008 to 2013. All of them were operated by a single surgeon via the unilateral approach. Twenty-two patients who exhibited radicular and/or myelopathic symptoms were enrolled in this study. All of them showed cervical cord compression in their preoperative magnetic resonance scan images. Results : In surgical outcomes, 14 patients (64%) were classified as excellent and six (27%), as good. The mean difference of cervical cord anterior-posterior diameter after surgery was 0.92 mm (p<0.01) and transverse area was $9.77mm^2$ (p<0.01). The dynamic radiological study showed that the average post-operative translation (retrolisthesis) was 0.36 mm and the disc height loss at the operated level was 0.81 mm. The change in the Cobb angle decreased to 3.46, and showed slight kyphosis. The average vertebral body resection rate was 11.47%. No procedure-related complications occurred. Only one patient who had two-level decompression needed anterior fusion at one level as a secondary surgery due to postoperative instability. Conclusions : Cervical cord decompression was successfully performed using EACF technique. This procedure will be an alternative surgical option for treating cord compressing lesions. Long-term follow-up and a further study in larger series will be needed.

• Journal of Korean Foot and Ankle Society
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• v.23 no.4
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• pp.173-182
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• 2019

Purpose: This study determined if anterior talofibular ligament (ATFL)/superior extensor ankle retinaculum (SEAR) thicknesses are related to dynamic balance in individuals with chronic ankle instability (CAI). Materials and Methods: The subjects were 14 males and 15 females (age=24.52±3.46 years). Ankle instability was assessed using the Cumberland Ankle Instability Tool (CAIT) with a cut off score of 25 to define two groups. SonoSite MTurbo (Fugifilm Sonosite, Inc.) musculoskeletal ultrasound (MSKUS) unit was used to assess ATFL and SEAR thicknesses. Dynamic balance was measured with the Y Balance Test (YBT) and two NeuroCom balance tests. Results: There were no significant differences in the average ATFL thickness between stable and unstable ankles in those subjects with CAI (0.25±0.03 cm and 0.21±0.05 cm, respectively) or in the SEAR thickness (0.09±0.04 cm and 0.10±0.03 cm, respectively). There were also no significant differences in the right and left ATFL thicknesses (0.23±0.07 cm and 0.21±0.04 cm, respectively) or the SEAR thicknesses (0.09±0.01 cm and 0.09±0.01 cm, respectively) in those without CAI. There were no differences between limbs in composite scores on YBT in those with CAI (p=0.35) and those without CAI (p=0.33). There was a moderate correlation between the left SEAR thickness and the large forward/backward perturbations on the NeuroCom (Natus) motor control test (r=0.51, p=0.006 and r=0.54, p=0.003, respectively). Conclusion: There were no differences in the ATFL/SEAR thicknesses or balance measures between or within the groups, likely because CAI is multi-factorial and related to mechanisms other than tissue changes alone. More sensitive technology and a better definition of the measurement process may provide more definitive results.

• Journal of Korean Foot and Ankle Society
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• v.18 no.3
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• pp.108-114
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• 2014

Purpose: Ligament reattachment technique using a suture anchor appears to show satisfactory functional outcomes and mechanical stability compared with conventional bone tunnel technique. This study was prospectively conducted in order to evaluate functional outcomes of modified Brostrom procedures using the suture bridge technique for chronic ankle instability in athletes. Materials and Methods: Twenty eight athletes under 30 years of age were followed for more than two years after undergoing the modified Brostrom procedure using the suture bridge technique. Functional evaluation consisted of the foot and ankle outcome score (FAOS), foot and ankle ability measure (FAAM) score. Range of motion and time to return to exercise were evaluated using a periodic questionnaire. Talar tilt angle and anterior talar translation were measured through stress radiographs for evaluation of mechanical stability. Results: FAOS improved significantly from preoperative mean 59.4 points to 91.4 points (p<0.001). Daily living and sport activity scores of FAAM improved significantly from preoperative mean 50.5, 32.5 points to 94.8, 87.3 points, respectively (p<0.001). Talar tilt angle and anterior talar translation improved significantly from preoperative mean $16.8^{\circ}$, 13.5 mm to $4.2^{\circ}$, 4.1 mm at final follow-up (p<0.001). Times to return to exercise were as follows: mean 10.2 weeks in jogging, 15.4 weeks in spurt running, 13.1 weeks in jumping, 11.5 weeks in walking on uneven ground, 9.1 weeks in standing on one leg, 7.2 weeks in tip-toeing gait, 8.4 weeks in squatting, and 10.6 weeks in descending stairs. Conclusion: Modified Brostrom procedure using the suture bridge technique showed satisfactory functional outcomes for chronic ankle instability in athletes. Optimal indication and cost-effectiveness of the suture bridge technique will be studied in the future.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.3
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• pp.27-37
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• 2018

PURPOSE: The purpose of this study was to investigate and evaluate muscle activity and foot pressure during gait, and isokinetic strength and balance in persons with functional ankle instability (FAI). METHODS: Nine healthy subjects (CON, n=9) without FAI and 11 patients (FAI, n=11) with FAI participated in the study after having been screened with an ankle instability instrument and a balance error scoring system. In addition, FAI was classified as non-involved (FAI-N) or involved (FAI-I), and CON was classified as dominant or non-dominant. All subjects were evaluated for isokinetic strength (plantar flexion, dorsiflexion, inversion and eversion of $30^{\circ}/sec$ and $60^{\circ}/sec$), balance (static and dynamic), muscle activity (tibialis anterior, peroneus longus and gastrocnemius) and foot pressure (static and dynamic) during gait. RESULTS: Results showed that plantar flexion (p<.05), dorsiflexion (p<.05), inversion (p<.01) and eversion (p<.00) of $60^{\circ}/sec$ were significantly decreased in FAI-I compared to those in FAI-N and CON. C 90 of static balance with eyes open (p<.01) and closed (p<.00) were significantly increased in FAI compared to those in CON. Forward position of dynamic balance (p<.01) was significantly decreased in FAI compared to that in CON. Gastrocnemius and peroneus longus of dynamic muscle activity (p<.01), left and right weight distribution of static foot pressure (p<.00) and pressure distribution of dynamic foot pressure (p<.00) were significantly decreased in FAI-I compared to those in FAI-N. CONCLUSION: We demonstrated that ankle strength, balance, muscle activity and foot pressure were significantly correlated with FAI.

• Journal of Korean Foot and Ankle Society
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• v.14 no.1
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• pp.47-52
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• 2010

Purpose: We report the clinical and radiographic result of ligament reconstruction using plantaris and total ankle replacement in end-stage ankle arthritis with ankle instability. Materials and Methods: The study is based on the 9 cases among total 48 patients of end-stage ankle arthritis that were treated with total ankle prosthesis and ligament reconstruction from 2007 to 2009 at least 12 months follow-up. We evaluated the VAS (Visual analogue scale) pain score, AOFAS (American orthopedic foot and ankle society) score and radiographic measurements. Results: Average age was 59.4 years (53~67 years) old. VAS pain score improved from preoperative average $8.2{\pm}0.9$ (range, 7~10) to $2.7{\pm}1.7$ (range, 0~6) and the AOFAS score improved from $46.4{\pm}14.6$ points (range, 23~69) to $80.1{\pm}9.3$ points (range, 65~95) at final follow-up. Anterior draw test improved $15.2{\pm}3.4$ mm (range, 12~23 mm) to $8.8{\pm}2.6$ mm (range, 6~13mm), varus stress test improved from $13.9{\pm}4.6^{\circ}$ (range, $10-18^{\circ}$) to $6.2{\pm}4.7^{\circ}$ (range, $2-18^{\circ}$) at final follow up. Conclusion: Plantaris ligament reconstruction is good option as part of the management of ankle instability with end-stage ankle arthritis. We achieved good clinical and radiographic results.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.134-139
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• 2011

Purpose: We wanted to review the arthroscopic Remplissage technique and introduce our experiences with it for treating recurrent shoulder instability with a large Hill-Sachs lesion. Materials and Methods: The arthroscopic Remplissage technique with Bankart repair is performed in patients with no osteoarthritis, no fracture around the shoulder, a history of recurrence more than 10 times, a large Hill-Sachs lesion more than 30 to 40% of the humeral articular surface and glenoid bone loss less than 20%. Results and Conclusion: For recurrent shoulder instability with a large Hill-Sachs lesion, the Remplissage technique resulted in a good outcome for the shoulder stability, and good clinical and functional results.

• Korean Journal of Applied Biomechanics
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• v.28 no.2
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• pp.135-141
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• 2018

Objective: The purpose of this study was to investigate the effect of functional ankle instability (FAI) and surgical treatment (ST) on postural stability and leg stiffness during vertical-drop landing. Method: A total of 21 men participated in this study (normal [NOR]: 7, FAI: 7, ST: 7). We estimated dimensionless leg stiffness as the ratio of the peak vertical ground reaction force and the change in stance-phase leg length. Leg length was calculated as the distance from the center of the pelvis to the center of pressure under the foot. Furthermore, the analyzed variables included the loading rate and the dynamic postural stability index (DPSI; medial-lateral [ML], anterior-posterior [AP], and vertical [V]) in the initial contact phase. Results: The dimensionless leg stiffness in the FAI group was higher than that of the NOR group and the ST group (p = .018). This result may be due to a smaller change in stance-phase leg length (p = .001). DPSI (ML, AP, and V) and loading rate did not show differences according to the types of ankle instability during drop landing (p > .05). Conclusion: This study suggested that the dimensionless leg stiffness was within the normal range in the ST group, whereas it was increased by the stiffness of the legs rather than the peak vertical force during vertical-drop landing in the FAI group. Identifying these potential differences may enable clinicians to assess ankle instability and design rehabilitation protocols specific for the impairment.