• Title/Summary/Keyword: Anterior instability

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Comparison of Superior Labral Anterior Posterior (SLAP) Lesions: Sports versus Non-sports Induced Injury (스포츠 손상과 비스포츠 손상에 의한 상부 관절와 순 전후방(SLAP) 병변의 비교)

  • Lee, Kwang-Won;Lee, Seung-Hun;Yang, Dong-Hyun;Kam, Byoung-Sup;Choy, Won-Sik
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.175-182
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    • 2007
  • Purpose: This study compared the SLAP lesions caused by a sports-induced injury with those caused by a non-sports-induced injury. Materials and Methods: The study was performed on 54 patients who had undergone arthroscopic surgery for a SLAP lesion. There were 21 sports-induced-injury patients (group I) and 36 non-sports-induced injury patients (group II). The mean age of the men was 36 years and that of the women was 48 years. In both groups, the frequency of a concomitant injury and the clinical outcomes at the last follow-up was evaluated using the UCLA score, Rowe score, and the ASES score. Results: According to their injury mechanism, , there were 14 cases (67%) of repeated microtrauma injury in group I and 25 cases (75%) of compression injury type in group II. As a concomitant pathology, there was 11 cases of shoulder instability and 5 cases of a rotator cuff tear in group I, and 23 cases of rotator cuff tears and 14 cases of shoulder instability in group II. At the last follow up, group I showed slightly better clinical satisfaction (P>0.05). Conclusion: The possibility of a SLAP lesion accompanying other diseases is high. Therefore, an accurate assessment of concomitant injury lesions before surgery is important for the treatment outcome.

Analysis of trunk and lower extremity muscle activity according to the compensation of arm during bridge exercise (교각운동시 팔의 보상작용에 따른 몸통 및 하지근육 활성도 분석)

  • Oh, Gku Bin;Kim, Se Hee;Kim, Ye Eun;An, Jun Sung;You, Si Yeon;Jung, Sang Jin;Cho, Ye Bin;Ju, Jin Han;Cho, Ki Hun
    • Journal of Korean Physical Therapy Science
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    • v.29 no.3
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    • pp.12-20
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    • 2022
  • Background: The purpose of this study was to investigate the changes of trunk and lower extremity muscle activity according to the compensation of arm during bridge movement of healthy subject. Design: Cross-sectional Study. Methods: Twenty healthy subjects participated in this study. The subjects performed bridge exercise with 3 different arm positions(arm abduction 45°, 90° and cross-arms) and measured the muscle activity of the trunk and lower extrimity. During bridge exercise with 3 different arm positions, trunk (rectus abdominis, erector spinae) and lower extrimity muscle activity (gluteus medius, biceps femoris, tibialis anterior) were measured using wireless surface EMG. Results: Rectus abdominis and gluteus medius muscle were most activated during bridge exercise with arm abduction 90° and erector spinae and biceps femoris muscle were most activated during bridge exercise with arm abduction 45°. In addition, tibialis anterior muscle was most activated during bridge exercise with arm cross. However, these difference in muscle activity according to the arm position was not statistically significant. Conclusion: As a result of this study, we think that the change in arm position does not induce sufficient instability to increase the muscle activity of the trunk and lower extremity muscles. Therefore, various approaches for inducing instability of the support surface for increasing muscle activity when applying bridge movement in clinical practice should be explored.

Clinical Evaluation of Surgical Treatments for Ten Cases of Tuberculous Spondylitis (결핵성 척추염 10례의 수술적 치료에 관한 임상적 고찰)

  • Whee, Sung Mock;Eoh, Whan;Nam, Do Hyun;Lee, Jung Il;Kim, Jong Soo;Hong, Seung-Chyul;Shin, Hyung Jin;Park, Kwan;Kim, Jong-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.30 no.11
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    • pp.1314-1319
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    • 2001
  • Objects : Because of the nonspecific nature of symptoms in tuberculous spondylitis, a delay in the diagnosis can result in progressive neurologic deficits. The authors evaluate the clinical and the radiological results of the 10 cases of surgically treated tuberculous spondylitis. Clinical materials & Methods : We retrospectively analyzed the medical records of 10 patients with tuberculous spondylitis who were treated between February 1996 and March 2000. Six patients were female, and four were male. Mean age was 43 years old, and mean follow-up period was 20.5 months. All patients were treated with 12 months of antituberculous medication postoperatively, and were followed by complete blood count, ESR, spine X-ray and MRI. Results : The lumbar spine was involved in 5 patients, the thoracic in 4, and the thoracolumbar in one. The infected vertebral bodies were 2.8 in average. The associated lesions were pulmonary tuberculosis in 3 cases, and renal tuberculosis in one. Five patients were treated by anterior debridement and fusion with bone graft using anterior instrumentation, 2 with anterior debridement and fusion with bone graft(Hong Kong procedure only), 1 with Hong Kong procedure with posterior spinal instrumentation, and 2 were managed with posterior debridement and posterior spinal instrumentation. All patients improved after operation, and the average kyphotic angle decreased postoperatively. Postoperatively, one patient had a fistula at the operative site. Conclusion : The debridement and minimal level fusion of motion segment with instrument fixation is one of surgical option for tuberculous spondyltis to preserve the spine motion segment as much as possible. Spine instability and kyphosis were prevented by anterior and posterior spinal instrumentation. But, large number of cases and longer period follow-up study in future will be needed to confirm the long term results.

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Arthroscopic Reconstrucion in Megafrequency of Recurrent Anterior Shoulder Dislocations (관절경을 이용한 고 빈도 재발성 전방 견관절 탈구의 재건술)

  • Ko, Sang-Hun;You, Chong-Il;Cho, Sung-Do;Choi, Chang-Hyuk;Cheon, In-Ho;Woo, Jong-Keun;Kwag, Chang-Yul;Yun, Dong-Jin;Choe, Seong-Won
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.194-200
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    • 2005
  • Purpose: To evaluate the short-term follow up outcome and the effectiveness of arthroscopic vertical shift of anteroinferior capsulolabral complex, plication of AIGHLC (anterior band of inferior glenohumeral ligament complex) and thermal capulorraphy, posteroinferior suture plication, rotator interval closure as an adjuncts in recurrent instability of megafrequency with night time dislocation. Materials & Methods: From March 1998 to February 2004, we have had 18 shoulders out of 156. All of the cases have been night time dislocation above more one time. The age were average 29.4$(21{\sim}37)$ year old. The average follow up were 21.1 $(12{\sim}45)$months We checked Rowe score and ROM at pre-operation, post-operation 6 months,1 year & last follow up period. Results: Above good results were 16 cases(88.9%). The excellent were 6 cases, good were 10, fair 1, poor 1. Conclusions: In recurrent anterior shoulder dislocation in greater than 50 frequency, arthroscopic stabilization can be an alternative technique for selected patients against open inferior capsular shift. But more long ter n follow up and large materials will be needed in the future study.

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Ligament Reconstruction for Subluxation of the Trapeziometacarpal Joint of the Thumb (무지의 대능형중수간 관절의 아탈구에 대한 인대 재건술)

  • Park Jin Soo;Chung Yung Khee;Yoo Jung Han;Na Kyong Soo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.2
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    • pp.134-140
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    • 2004
  • Purpose: The reconstructive surgery of the anterior oblique ligament has been recommended for patients with unstable carpometacarpal joints. We reviewed retrospectively the functional results of two patients who had been treated by6 using a harvested portion of the tendon of flexor carpi radialis as a substitute for the anterior oblique ligament. Materials and Methods: In two patients with a instability of the trapeziometacarpal joint because of a rupture of the anterior oblique ligament, reconstruction was carried out using a slip of the tendon of flexor carpi radialis and the patients had been followed up for two years. Results: The results after a follow-up of two years that both of them had significant relief from pain and symptoms. The mean grip strength recovered to 90$\%$ of the controlateral side. patients felt that they had subjective improvement and would have undergone the operation again. Conclusion: Increased awareness of this lesion can lead to an early and clear diagnosis, so that the patient may be advised adequately.

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Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft - The comparison of mid term & long term follow-up results - (골-슬개 건-골을 이용한 전방 십자 인대 재건술 - 중기 및 장기 추시 결과의 비교 -)

  • Song Eun Kyoo;Yoon Taek Rim;Lee Young Keun;Kim Jong Seok
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.117-122
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    • 2000
  • Purpose : To compare the mid term with long term follow up results of the anterior cruciate ligament(ACL)> reconstruction using patellar tendon. Materials and Methods : Seventy-six cases, which could be followed up more than 2 years were included in this study. They were classified into two groups, mid-term group(41 cases) with mean follow-up periods of 2 years and 10 months and long-term group(35 cases) off years and 6 months. Clinical and radiological results and peripatellar complications were evaluated & compared. Results . There was no statistically significant difference in radiological finding and anterior instability between two groups. However, the incidence of anterior knee pain, paresthesia at incision site, kneeling pain, crepitus and quadriceps weakness was lower in long-term group than in mid-term group. Conclusion : ACL reconstruction using patellar tendon graft could successfully restone the stability of knee joint, but there are some complications in donor site and patellofemoral joint. However this complications were gradually decreased with long term follow-up.

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Arthroscopic Treatment of Partial-thickness Rotator Cuff Tear

  • Kim Seung-Ho;Ha Kwon-Ick
    • Clinics in Shoulder and Elbow
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    • v.1 no.2
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    • pp.266-277
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    • 1998
  • Forty-nine partial thickness rotator cuff tears underwent arthroscopic debridement or repair, and were followed up for a minimum of two years. Follow-up evaluations of the results were completed using a detailed functional questionnaire which was comprised of a rating of the UCLA shoulder scale and return to the previous sports activity and job. The average age of the 49 study patients was 46.5 years(range, 14 to 67 years). The patients were divided into four groups on the basis of the onset of the patient's symptoms. Thirty-five patients(72%) had partial tearing only on the articular surface, six(12%) on the bursal surface, and eight(16%) on both surfaces. Group I consisted of 21 patients with an average age of 56.7. Partial tearing in group I was attributed to the impingement syndrome. In group II, partial tearing of the rotator cuff was related to the anterior instability of the shoulder. This group included 9 patients with an average age of 27.9. In group III, all of the 8 patients were overhead athletes with an average age of 21.8. In this group, no isolated instances of significant trauma were related to the development of the shoulder pain. In group IV, 11 patients noted that a significant traumatic event preceded the onset of their pain. The average age of the patients was 34.9. Overall, 82% of the patients demonstrated satisfactory results and 18% revealed unsatisfactory results. The worst UCLA score and rate of return to the prior activity was noted in group III. In conclusion, partial thickness rotator cuff tear can be caused by subacromial impingement, instability, repetitive microtrauma, and macrotrauma. Arthroscopic debridement of partial tear of the rotator cuff provides a favorable outcome except in overhead athletes.

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Type Ⅱ SLAP Lesion with the Rotator Cuff Tear (회전근개 파열과 동반한 TypeⅡ SLAP 병변)

  • Kim Jin Sub;Whang Pil Sung;Yoo Jung Han
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.115-119
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    • 1999
  • Purpose: We reviewed the SLAP lesions and associated injuries, also evaluated a hypothesis that the type II posterior SLAP lesion is related with posterior rotator cuff tear and gives rise to the postero-superior instability. Materials and Methods: The patient recording papers, MRI, video and operation sheets were reviewed with the 28 SLAP lesions confirmed by the arthroscopy among 242 cases. Among these SLAP lesions, type II was 22 cases and classified to the anterior, posterior(16 cases), combined subtype(6 cases) based on the main anatomic location. There were 14 cases of the type II accompanying rotator cuff tear. The average follow-up(13 months) results were evaluated with the ASES and Rowe rating score after repair or debridement of the SLAP lesions. Results: In the type II lesions accompanying the rotator cuff tears(14 cases), the posterior(l0 cases) and combined type(4 cases), cuff lesions were all existed posteriorly. Also We could confirm the drive-through sign in the eleven cases, though did not check the disappearance of this sign after repair because of retrospective study. We could followed up the 22 cases, 18 cases(77%) were excellent or good, fair 3 cases(14%) and poor 1 case(4%). Also, type II lesions with the rotator cuff tear(14 cases) were showed better results in the repair(8 cases) than the debridement(6 cases) of the unstable type II with the cuff repair. Conclusion: The type II lesions were frequently associated with the cuff tear in the specific location. We could presume the possibility of postero-superior instability in the SLAP lesion with the cuff injuries. Also, satisfactory results could be experienced when the unstable SLAP lesions with the cuff tear were repaired at the same time.

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Effects of Abnormal Neck Posture on Postural Stability (목 자세에 따른 선 자세에서의 신체균형능력 평가)

  • Park, Sung Ha
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.41 no.2
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    • pp.16-23
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    • 2018
  • Postural instability can increase the likelihood of hazardous slip and fall accidents in workplaces. The present study intended to extend understanding of the effect of abnormal neck posture on postural control during quiet standing. The effect of body fatigue on the postural control was also of primary concern. Twelve healthy undergraduate students volunteered to participate in the experiment. Standing on a force platform with the neck neutral, flexed, extended, or rotated, subjects' center of pressures (COP) were measured under the two levels of body fatigue. For the fatigue condition, Subjects exercised in a treadmill to meet the predetermined level of body fatigue. Analyzing the position coordinates of COPs, the length of postural sway path was assessed in both medio-lateral (ML) axis and anterior-posterior (AP) axis. Results showed that, in AP direction, neck extension or rotation significantly increased the sway length as compared with neck neutral. Neck extension led to greater sway length compared to neck rotation. Neck flexion did not differ from neck neutral. The sway length in the AP direction also became significantly larger as the body fatigue accumulated after treadmill exercise. In ML direction, as compared to neutral posture, the neck extension, flexion, or rotation did not significantly affect the length of postural sway path. However, the sway length seemed to increase marginally with the neck extended during the fatigued condition. This study demonstrates that abnormal neck posture may interfere with postural control during standing. The ability to maintain postural stability decreases significantly with the neck extended or rotated. Body fatigue leads to postural instability further.

Comparison of the Upper and Lower Trapezius and Serratus Anterior during Push-up Plus Exercise with and without an Elastic Shoulder Band

  • Kim, Kyeong-Jin;Woo, Hye-Jin;Hong, Yu-Jeong;Hwang, Young-In
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.3
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    • pp.75-80
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    • 2018
  • PURPOSE: Scapular stability is very important to arm function during activities of daily living. The push-up plus exercise is commonly used to stabilize the shoulder muscles. In the present study, we designed an elastic shoulder band (ESB) that could be used with the push-up plus exercise and studied muscle activities of the serratus anterior (SA) and the lower and the upper trapezius (LT and UT) on stable and unstable support. METHODS: Fifteen healthy people participated in this study. Three muscles were investigated using surface EMG with and without the ESB on stable and unstable support. All subjects performed each trial three times for 7 seconds per set and rested for 30 seconds. Repeated one-way ANOVA was used for statistical analyses. RESULTS: The EMG activity of the SA was significantly different during the push-up plus exercise on stable support with the ESB compared with that on unstable support without the ESB (p<.05). However, there were no differences in the activities of UT and LT on stable and unstable support (p>.05). CONCLUSION: The ESB was effective for the activity of SA during the push-up plus exercise on stable support; therefore, it has the potential for use by people during push-up plus exercises. However, further studies are required to investigate the rehabilitation tools for patients with shoulder instability.