• 제목/요약/키워드: Anterior instability

검색결과 285건 처리시간 0.021초

후방 및 후외측 불안정성 슬관절 (Posterior and Posterolateral Instability of Knee Joint)

  • 이동철
    • 대한관절경학회지
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    • 제7권2호
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    • pp.127-136
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    • 2003
  • 슬관절 후외측방 불안정성은 전방 및 후방 십자인대 손상과 흔히 동반되며 이 동반된 손상은 심각한 기능적 불안정성 및 관절 연골의 변성을 초래하게된다. 슬관절의 후외측 구조물 손상이 있는 경우 적절한 치료 없이 전방 및 후방 십자인대 재건술만 시행할 경우 십자인대 재건술이 실패하게된다. 이를 방지하기 위해 자세한 이학적 검사, 방사선 검사를 시행하여야하며 하지정열축 및 보행 형태를 평가하여야 한다. 급성 후외측방 구조물의 3등급 단독 손상이나 동반 손상에서는 3주이내에 일차 봉합을 하거나, 봉합이 어려울 경우 보강수술이나 재건수술을 시행하는 것이 좋다. 후방 및 후외측방 재건술에서 다양한 수술 방법 중 적절한 방법을 선택하여 동시에 시행하거나 2단계 재건수술을 가능한 빨리 시행하여야 한다. 만약 만성 후외측 불안정성 슬관절에서 내반 정열이 있으면서 varus thrust gait가 있는 경우 외측 연부조직 재건술로는 해결하기가 어려우므로 먼저 외반 절골술을 시행하여야 하고 약 6개월 뒤에 후외측 불안정성을 재평가하여 이후 연부조직 재건술을 시행할 수도 있다.

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골 결손을 동반한 견관절 불안정성의 관절경적 재건술 (Arthroscopic Reconstruction of Bony Defect in Shoulder Instability)

  • 김양수;옥지훈
    • Clinics in Shoulder and Elbow
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    • 제14권1호
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    • pp.117-124
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    • 2011
  • 목적: 골성 방카르트 병변의 여러 가지 치료 방법 중 관절경적 재건술에 대하여 문헌 고찰과 함께 대략적으로 설명하기로 한다. 대상 및 방법: 견관절 전방 불안정성의 치료에 있어 관절경적 복원술의 임상결과 향상으로 개방적 수술보다 관절경적 수술을 더욱 선호하게 되었고 점차 표준 치료법으로 인정받게 되었다. 그러나 관절와의 골 결손이 있는 경우 골 결손의 정도를 측정하는 방법은 연구자에 따라 다양하며 관절경적 복원술의 방법 또한 지속적 발전과 함께 다양하게 소개되고 있다. 결과: 골 결손의 관절경적 재건술 중 방카르트 병변의 이열 봉합술은 일열 봉합술의 단점을 보완하여 보다 견고한 고정과 해부학적 복원을 위해 최근에 소개되었으나 앞으로 많은 증례와 장기간 추시를 통해 그 결과가 입증되어야 할 것이다. 또한 관절경을 이용한 오구돌기 이전술, 즉 Bristow-Latarjet 술식 등 여러 가지 방법이 시도되고 있다. 결론: 전방 불안정성 환자의 관절경적 치료 방법은 다양하게 시도되고 있으며 지속적인 발전을 거듭하고 있다. 성공적인 결과를 얻기 위해서는 수술 전 환자의 골 결손 상태를 정확히 파악해야 하며 치료와 연관된 술 중, 술 후 요소들을 잘 알고 있어야 한다.

Comparison of Hip Joint Strength between Young Woman Patient with Chronic Low Back Pain with Lumbar Instability and Normal Subjects

  • Cha, Hyun Gyu
    • Physical Therapy Rehabilitation Science
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    • 제11권3호
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    • pp.370-375
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    • 2022
  • Objective: The purpose of this study was to compare the hip joint muscle strength of patients with chronic back pain with lumbar instability and normal subjects. Design: A case control study. Methods: Five types of lumbar instability test were conducted on forty young women with chronic low back pain for more than six months, and those who had 3 or more positive tests were selected as subjects. To select chronic back pain patients with lumbar instability group, aberrant movement patterns during lumbar flexion test (FMT), prone instability test (PIT), posterior-anterior mobility test (PAT), passive lumbar extension test (PLE), and pressure bio-feedback (PBF) were applied. In addition, a digital muscle strength meter was used to measure the hip flexor, extensor, adductor, and abductor muscles of chronic low back pain patients with lumbar instability group (n=20) and normal subject group (n=20). Results: As a result of comparing the hip joint muscle strength between the chronic back pain patient group with lumbar instability and the normal group, there were significant differences in the hip extensor, abductor, and adductor muscles (p<0.05). Conclusions: Patients of chronic back pain with lumbar instability were found to have weak hip joint muscle strength. Therefore, this study suggest that include hip joint strength exercise for functional recovery of chronic back pain patients.

Effect of Ankle Stabilization Training Using Biofeedback on Balance Ability and Lower Limb Muscle Activity in Football Players with Functional Ankle Instability

  • Kim, Je-Ho;Uhm, Yo-Han
    • The Journal of Korean Physical Therapy
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    • 제28권3호
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    • pp.189-194
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    • 2016
  • Purpose: This study focuses on influence of ankle stabilization training on balance ability and lower limb muscle activation of soccer player with functional ankle instability. Methods: Subjects were grouped into ankle stabilization training group using biofeedback comprised of 15 subjects and general exercise group of 15. The training was conducted for 30 minutes, 3 times a week for 8 weeks in total. All 30 football players conducted plyometric training for 30 minutes before main training. To evaluate balance ability, biorescure was used to measure whole path length and surface area and surface electromyography (EMG) system was used to measure tibialis anterior, tibialis posterior, and soleus to evaluate lower limb muscle activation. Results: The experiment group showed significant difference to the comparison group in regard of whole path length and surface area which represents balancing capability and muscle activation of tibialis anterior, tibialis posterior, and soleus. Conclusion: Therefore, ankle stabilization training using biofeedback is more effective in enhancing balance ability and lower limb muscle activation than general exercise.

저명한 불안정성을 가진 만성 족관절 염좌 환자의 족관절 골성 병변에 대한 분석 (Analysis of Ankle Bony Abnormality in the Patients with Chronic Ankle Sprain and Marked Ankle Instability)

  • 정철용;은일수;김병철;최성종;류총일;김종균;최현수
    • 대한족부족관절학회지
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    • 제10권1호
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    • pp.7-10
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    • 2006
  • Purpose: We analyzed the ankle bony abnormality of patients with marked ankle instability who had chronic ankle sprain more than 3 years. Materials and Methods: We evaluated the chronic ankle sprain (more than 3 years) patients with marked ankle instability tested by varus stress test and anterior draw test from March 2000 to December 2005. Eighty-nine patients (104 ankle) were evaluated and there were 38 males and 51 females. The mean age of patient at the time of diagnosis was 34.5 (range, 18 to 56 years). The average duration of morbidity was 7 years and 3 months (range, 3 years and 3 months to 21 years). The patients who had history of dislocation, fracture, malalignment, operated patients, and rheumatoid ones were excluded. Plain radiographs of AP, lateral, oblique and mortise view were checked. Results: Radilologic abnormalities were found at 74 ankles (71%) among 104 ankles. Frequent sequences of location were anterior talotibial osteophyte, medial malleolar osteophyte, Os subfibulare, lateral malleolar osteophyte. Posteior osteophyte, ankle arthritis, talar articular defect were rarely found. Conclusion: Seventy-one percent among patients with chronic ankle sprain and marked ankle instability showed more than one radiologic abnormalities. Thus, more exclusive and accurate ankle examination should be performed in these patients.

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다방향성 불안정 견관절의 관절경을 이용한 치료 (Arthroscopic Treatment in Multidirectional Instability of the Shoulder Joint)

  • 이광진;변기용;권순태;김상범
    • Clinics in Shoulder and Elbow
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    • 제1권1호
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    • pp.40-45
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    • 1998
  • Multidirectional instability of the shoulder joint is an unusual entity which is not yet well understood. Traditionally recommended treatment is non-operative, but recently arthroscopic treatment has been performed. This is a retrospective review of 20 patients who had multidirectional instability, who had been treated with arthroscopic capsular shift(7 cases), and arthroscopic treatment using Ho:YAG laser(l3 cases) at Department of Orthopaedic Surgery, Chungnam National University Hospital from July, 1988to February, 1997. Results of this study were as follows: 1. In five patients who were treated with arthroscopic anterior capsular shift only, all cases had redislocation of the shoulder joint. But there was no redislocation in two patients who were treated with arthroscopic anterior and posterior capsular shift. 2. ln three patients who were treated with laser-assisted capsular shift only, all cases had redislocation of the shoulder joint. But there was only one redislocation in ten patients treated with laser-assisted capsular shrinkage and capsular plication. Ho: Y AG laser has been found to be a safe and efficacious adjunct to many arthroscopic shoulder procedures. We had satisfactory results by combining a transglenoid capsular shift with laser-assisted capsular shrinkage. Arthroscopic laser-assisted capsular shrinkage and capsular plication is a one of recommendable treatment options in multidirectional instability of the shoulder joint.

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Risk Factors for Recurrence of Anterior Shoulder Instability after Arthroscopic Surgery with Suture Anchors

  • Choi, Chang-Hyuk;Kim, Seok-Jun;Chae, Seung-Bum;Lee, Jae-Keun;Kim, Dong-Young
    • Clinics in Shoulder and Elbow
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    • 제19권2호
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    • pp.78-83
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    • 2016
  • Background: We investigated the risk factors for the recurrence of anterior shoulder instability after arthroscopic surgery with suture anchors and the clinical outcomes after reoperation. Methods: A total of 281 patients (February 2001 to December 2012) were enrolled into our study, and postoperative subluxation and dislocation were considered as recurrence of the condition. We analyzed radiologic results and functional outcome including the American Shoulder and Elbow Surgeons Evaluation Form, the Korean Shoulder Society Score, and the Rowe scores. Results: Of the 281 patients, instability recurred in 51 patients (18.1%). Sixteen out of 51 patients (31.4%) received a reoperation. In terms of the functional outcome, we found that the intact group, comprising patients without recurrence, had a significantly better functional outcome than those in the recurrent group. The size of glenoid defect at the time of initial surgery significantly differed between intact and recurrent group (p<0.05). We found that the number of dislocations, the time from the initial presentation of symptoms to surgery, and the number of anchor points significantly differed between initial operation and revision group (p<0.05). The functional outcome after revision surgery was comparable to intact group after initial operation. Conclusions: Eighteen percent of recurrence occurred after arthroscopic instability surgery, and 5.6% received reoperation surgery. Risk factors for recurrence was the initial size of glenoid defect. In cases of revision surgery, good clinical outcomes could be achieved using additional suture anchor.

Effects of Kinesio Taping and Massage Application to Calf Muscle on Ankle Stability

  • Kim, Chan-Woo;Roh, Hyo-Lyun
    • 대한물리의학회지
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    • 제13권4호
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    • pp.35-42
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    • 2018
  • PURPOSE: This study was conducted to investigate the effects of Kinesio taping and massage application to the calf muscles on ankle stability. METHODS: The study subjects were 66 healthy adults (male: 32, female: 34) who had no instability in their ankles. Subjects were randomly assigned to a Kinesio taping group or a massage group. The research tool used the Y-balance test to measure instability of the ankle. The distance between the right and left foot was measured from the center in the anterior, posterior-medial, and posterior-lateral directions. Massage was applied to the calf muscles three times over two weeks and Kinesio tape was attached to the calf muscle and tibialis anterior for 10 hours twice during the experimental period. RESULTS: The results showed that application of Kinesio taping resulted in increases in the distance between the feet increased in some directions. After the massage, the distance extended from the anterior and posterior-lateral directions was prolonged, and the ankle stability on the right and left sides was partially improved by massage application. CONCLUSION: Kinesio taping and massage applied to the calf muscles are appropriate interventions for the improvement of ankle stability. Based on the application times of massage, Kinesio taping appears to work more effectively for ankle stability.