• Title/Summary/Keyword: Articular gap

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Correlation Analysis of Reduction for Intra-Articular Calcaneal Fracture and Clinical Outcomes Using Postoperative Computed Tomography (수술 후 컴퓨터 단층촬영을 이용한 관절 내 종골 골절의 정복과 임상 결과 간의 연관성 분석)

  • Eom, Joon-Sang;Joo, Young-Deuk;Kim, Seong-Jun;Shin, Min-Ho;Lee, Dong-Oh;Jung, Hong-Geun
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.4
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    • pp.165-172
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    • 2014
  • Purpose: We evaluated the correlation of postoperative clinical outcomes and radiologic findings using computed tomography and simple X-ray in intra-articular calcaneal fractures. Materials and Methods: The current study is based on 41 feet, 38 patients with displaced intra-articular fracture who underwent surgical treatment with at least one year of follow-up. Evaluation of clinical outcome included American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS) score, and subjective satisfaction. A simple X-ray was used in evaluation of preoperative and postoperative Gissane angle, B${\ddot{O}}$hler angle, and calcaneal fracture width. Computed tomography scan was performed for evaluation of preoperative and postoperative articular step-off and articular gap in all cases. Finally, we evaluated the correlation of the postoperative clinical outcomes and radiologic findings based on the measurement. Results: The average postoperative AOFAS score and VAS score was $84.1{\pm}8.5$ and $2.2{\pm}2.2$. Subjective satisfaction was excellent in 15 cases, good in 19 cases, and fair in seven cases. The average B${\ddot{O}}$hler angle was restored from $11.1^{\circ}$ to $24.7^{\circ}$(p<0.05), Gissane angle was changed from $121.0^{\circ}$ to $119.0^{\circ}$ (p>0.05), and the average width was restored from 45.8 to 35.0 mm (p<0.05). The average articular step-off and gap were decreased from 6.3 to 2.0 mm and from 11.1 to 4.6 mm, respectively (p<0.05). No significant correlations were observed between the clinical outcome and Gissane angle, B${\ddot{O}}$hler angle, and width, and there was no significant correlation between the clinical outcome and Sanders classification. However, postoperative articular step-off showed correlation with VAS and AOFAS score and articular gap showed correlation with VAS score. Conclusion: The clinical outcome did not show correlation with B${\ddot{O}}$hler angle and Gissane angle but did show correlation with anatomical reduction of the posterior facet joint.

A study on the correlation between airway space and facial morphology in Class III malocclusion children with nasal obstruction (비폐쇄를 보이는 III급 부정교합아동의 기도 공간 형태와 안모 골격 형태와의 상관관계 연구)

  • Jung, Ho-Lim;Chung, Dong-Hwa;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.37 no.3 s.122
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    • pp.192-203
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    • 2007
  • Objective: The aim of this study was assessment of the relationship between airway space and facial morphology in Class III children with nasal obstruction. Methods: For this study, 100 Class III children (50 boys and 50 girls) were chosen. All subjects were refered to ENT, due to nasal obstruction. Airway space measurements and facial morphology measurements were measured on lateral cephalometric radiograph. Pearson correlation analysis was used to assess the relationship between airway space and facial morphology Results: Ramal height, SNA, SNB, PFH, FHR and facial plane angle were positively related to upper PAS, and sum of saddle angle, articular angle, and genial angle, SN-GoGn, Y-axis to SN and FMA negatively related to upper PAS. Genial angle, FMA were positively related to lower PAS, and articular angle, facial depth, PFH and FHR negatively related to lower PAS. PCBL, ramal height, Mn. body length, Mn. body length to ACBL, facial depth, facial length, PFH and AFH were positively related to tonsil size. Sum of saddle angle, articular angle, genial angle, facial length, AFH, FMA and LFH were positively related to tongue gap, and IMPA and overbite was negatively related to tongue gap. Upper PAS, related to size of adenoid tissue, was mainly related to posterior facial dimension following a vertical growth pattern of face and mandibular rotation. Lower PAS and tonsil size, related to anterior-posterior tongue base position, were significantly related to each other. Lower PAS was related to growth pattern of mandible, and tonsil size was related to size of mandible and horizontal growth pattern of face. Tongue gap was related to anterior facial dimension following a vertical growth pattern of face. Conclusion: Significant relationship exists between airway space and facial morphology.

Is an Arthroscopically Assisted Reduction and Fixation Necessary in the Medial Malleolar Fracture of the Ankle? (족관절 내과 골절시 보조적 관절경적 정복 및 내고정술이 필요한가?)

  • Shin, Dong Min;Ju, Pyong
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.93-96
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    • 1998
  • We treated 10 cases of the medial malleolar fracture of the ankle by open reduction and internal fixation from June 1997 to December 1997. After the rigid internal fixation, we measured the gap of the fracture site and the step off of the articular surface by special instrument under the ankle arthroscopy whether it was reduced anatomically or not. And we tried to know the necessity of the arthroscopically assisted reduction and fixation in the medial malleolar fracture of the ankle. Under the arthroscopic view, all 10 cases were anatomically reduced as less than 1 mm of gap of the fracture site and less than 1mm of step off of the articular surface after open reduction and internal fixation in the medial malleolar fractures. In conclusion, through the arthroscopic management, it has advantage in finding and treating the accompanying intraarticular lesion, but also has disadvantage in setting the arthroscope and prolonging the operation time.

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Modified Essex-Lopresti Reduction for the Displaced Intra-articular Calcaneal Fractures (전위된 관절 내 종골 골절에 대한 Essex-Lopresti 변형 정복술)

  • Kwak, Kyoung-Duck;Cho, Hyoun-Oh;Lim, Dae-Hwan;Ahn, Sang-Min;Jang, Jae-Ho
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.1
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    • pp.109-114
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    • 2003
  • Purpose: The purpose of this study is to evaluate the effectiveness and indications of the modified Essex-Lopresti reduction in calcaneal fractures. Materials and Methods: We reviewed retrospectively 41 cases of displaced intraarticular calcaneal fractures. The fracture was reduced with Essex-Lopresti technique with modification in compression of the lateral wall with the specially designed compression device instead of the operator's hands. We evaluated the results of treatment by AOFAS scale and the radiographic parameters including the Bohler's angle, calcaneal width, calcaneofibular distance and the congruency of the posterior facet. Results: Boler's angle was restored from 11 to 29.6 degrees on average, heel width was reduced to 112% of contralateral value, the calcaneofibular gap was restored up to 87.9% of contralateral side, and the articular surface of the posterior facet was restored less than 2 mm of step off and less than 2 mm of gap. AOFAS scale averaged 87 points. The quality of reduction was best in Sander's type II fractures. Small sized fragments in type III fractures could not be reduced. The results were better when the reductions were performed within 24 hours of injury. Conclusion: The modified Essex-Lopresti reduction was less invasive, easy to perform, and the results of treatment were similar to those of open reduction; it seemed to be a reasonable alternative for the selected intraarticular calcaneal fractures.

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Result of Surgical Treatment of Intra-Articular Fractures of the Calcaneus - Based on CT Classification and Open Reduction and Internal Fixation - (종골 관절내 골절의 수술적 치료 후 임상 결과 -전산화 단층 촬영에 따른 분류 및 관혈적 정복 및 내고정 치료-)

  • Kim, Eui-Soon;Seo, Hyun-Mo;Lee, Kyu-Min;Choi, Hun-Hwi;Moon, Myung-Sang;Lee, Man-Hee;Choi, Won-Tae
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.238-249
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    • 2003
  • Purpose: To report the clinical result of the intraarticular calcaneus fracture after open reduction and internal fixation with plate by lateral approach. Materials and Methods: Thirty-six calcaneal fractures of 33 patients(29 men and 4 women) were treated by open reduction and internal fixation using an lateral approach from March, 1997 to May, 2002 and were followed more than one year. The autogenous iliac bone graft was done in 2 cases but the others didn't. Radiographically B?hler angle and Gissane angle on simple lateral radiograph were measured and in the 15 cases, the step-off(gap) of posterior facet joint on post-operative CT images were followed. The Salama method was used for evaluation of clinical results. Results: According to Sanders classification, 19 cases of the 36 cases were classified as type II. Type III fracture were found in 12 cases and type IV in 5 cases. The following results were obtained: twenty-two cases(61.1%) out of 36 cases were estimated as good or excellent. The good results or more were obtained in 15 cases(78.9%) in type II and 7 cases(58.3%) in type ill, but no case in type IV. B?hler angles were improved from preoperative average 1.6?to postoperative average 23.4?, Gissane angle was improved from preoperative 107.2?to postoperative 122.8?, respectively. Among 36 cases, Computed tomography was carried out in 15 cases. The postoperative step-off (gap) of posterior facet joint on computed tomography was filled with cancellous bone. Satifactory results was obtained in 7 cases with 2mm gap or less and in 6 cases of 2-5mm. There were no satifactory results in 2 cases with 5mm gap or more. Conclusion: Open reduction and internal fixation for intra-articular fracture of calcaneus was thought to be a good treatment modality. It is thought that the lateral approach is one of the good one for surgical treatment, and that accurate reduction of the posterior facet, acceptable recovery of B?hler angle are more important to obtain best results.

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Analysis of the Calcaneocuboid Joint Involvement in Intraarticular Calcaneal Fractures (관절내 종골 골절에서 종입방 관절 침범 분석)

  • Shin, Won-Ju;Yang, Sang-Hoon;Park, Hong-Ki
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.42-47
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    • 2006
  • Purpose: This study was performed to analyze the characteristics of calcaneocuboid joint involvement in intraarticular calcaneal fractures. Materials and Methods: Total number of 92 patients (111 cases) who underwent operation for intraarticular calcaneal fractures between Jan. 2000 and Oct. 2005 were included in this study. The preoperative computed tomographs of the subjects were retrospectively reviewed to analyze calcaneocuboid joint involvement. Results: It was revealed that 63 cases (56.8%) involved calcaneocuboid joint; 29cases (46.0%) showed type 1 (undisplaced or minimally displaced type, articular gap ${\le}1\;mm$), 16 cases (25.4%) exhibited type 2 (moderately displaced type, articular gap ${\ge}2\;mm$), 7 cases (11.1%) were included in type 3 (comminuted type) and 11 cases (17.5%) belonged to type 4 (fracture and dislocation). 48 out of 63 cases belonged to Sanders classification II and III that involved calcaneocuboid joint and included 25 cases (52.1%) of type 1 and 14 cases (29.2%) of type 2. Among 15 out of 63 cases included in Sanders classification IV, 4 (26.7%) showed type 1 and 6 (40.0%) belonged to type 4. According to our results, Sanders classification allowed to predict pattern of the involvement of calcaneocuboid joint (P<0.05). However, there was no statistically significant relationship between degree of posterior facet joint injuries and calcaneocuboid joint involvement (P>0.05). Conclusion: Calcaneocuboid joint involvement in intraarticular calcaneal fractures was common and more than half showed severe injuries. We concluded that further studies on the involvement of calcaneocuboid joint should be performed prior to surgical treatment of intraarticular calcaneal fractures.

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A case of ilium fused with sacrum in Chinese water deer (Hydropotes inermis) (고라니(Hydropotes inermis) 장골과 천골이 유합된 1례)

  • Kim, Chong-Sup;Koh, Phil-Ok;Cho, Kyu-Woan;Cho, Jae-Hyeon;Won, Chung-Kil
    • Korean Journal of Veterinary Research
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    • v.45 no.4
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    • pp.465-467
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    • 2005
  • The sacrum fused with ilium in a chinese water deer (Hydropotes inermis) was observed. The sacrum consists of four sacral vertebrae which was fused each other. In the ventral part of the fused pelvis, on the left, there was a 20.19 mm gap at the dorsolateral part of the sacroiliac articular part which is in between the promontory and the cranial border of the first ventral sacral foramen. On the right, there was a 14.34 mm gap at the dorsal part of sacroiliac articulation. In the dorsal view of the fused pelvis, the wing of sacrum and the wing of ilium were fused tightly, so that the boundary of the two bones was not recognizable. The left and right second dorsal sacral foramina and the third dorsal sacral foramen on the left were small. The third dorsal and ventral sacral foramina on the right were not formed.

Acromioclavicular joint dislocation and concomitant labral lesions: a systematic review

  • Jad Mansour;Joseph E Nassar;Michel Estephan;Karl Boulos;Mohammad Daher
    • Clinics in Shoulder and Elbow
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    • v.27 no.2
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    • pp.247-253
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    • 2024
  • Acromioclavicular (AC) joint dislocations frequently co-occur with intra-articular glenohumeral pathologies. Few comprehensive studies have focused on labral tears specifically associated with AC joint trauma. This systematic review will address this gap. A comprehensive electronic search was conducted across PubMed, Cochrane Library, and Google Scholar (pages 1-20) spanning from 1976 to May 19, 2023. Seven studies met the inclusion criteria for this systematic review, consisting of three retrospective studies and four case series. These studies collectively involved 1,044 patients, of whom 282 had concomitant labral lesions. The pooled prevalence of intra-articular labral injuries associated with acute AC joint dislocation was 27%. The prevalence of these labral lesions varied significantly between studies, ranging from 13.9% to 84.0% of patients, depending on the study and the grade of AC joint dislocation. Various types of labral tears were reported, with superior labrum anterior to posterior (SLAP) lesions being the most common. The prevalence of SLAP lesions ranged from 7.2% to 77.4%, with higher grades of AC joint dislocations often associated with a higher prevalence of SLAP tears. Moreover, grade V dislocations exhibited a complete correlation with SLAP tears. The studies yielded contradictory findings regarding older age and higher grades of AC joint dislocation as risk factors for concurrent labral lesions. This review underscores the frequent association between labral lesions and AC joint dislocations, particularly in cases of lower-grade injuries. Notably, SLAP lesions emerged as the predominant type of labral tear.

The suture bridge transosseous equivalent technique for Bony Bankart lesion

  • Choe, Chang-Hyeok;Kim, Sin-Geun;Baek, Seung-Hun;Sin, Dong-Yeong
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2008.03a
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    • pp.178-178
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    • 2008
  • In order to improve static stability and healing of reattached labrum, we combined the advantages of suture bridge and transosseous technique. Using the conventional 3 portal for anterior instability, check stability of bony Bankart and preparation of glenoid bed in 3 way including removal, reshaping or mobilization of bony fragment. Two anchors were inserted to the superior and inferior portion and medial edge of bony Bankart lesion. It usually corresponded to the area of IGHL. Medial mattress sutures were applied around IGHL complex to get enough depth of glenoid coverage using suture hook. Make 3.5mm pushlock anchor hole to the articular edge of glenoid cartilage. Proximal suture bridge was applied at first and then distal suture bridge was inserted to mobilize the labrum in proximal direction. These construction can provide more stable labral repair with wide contact and compression in case of deficient bony stability. It not only avoids technical disadvantage of point contact with anchor fixation, but also decreasing gap formation through cross compression of labrum that couldn't gain even with the transosseous fixation which affords linear compression effect. Additional bony stability could be gained if the the bony fragment was mobilized to the glenoid margin with potential healing bed or reshaped for the good contact with reattached labrum.

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Reduction Loss after Extension Block Kirschner Wire Fixation for Treatment of Bony Mallet Finger (골성 추지 신전제한 K 강선 고정술 시행 후 정복소실)

  • Kim, Byungsung;Nho, Jae-Hwi;Jung, Ki Jin;Yun, Keonhee;Park, Eunseok;Park, Sungyong
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.239-247
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    • 2018
  • Purpose: We investigated occurrence of reduction loss after extension block (EB) Kirschner wire fixation or additional interfragmentary fixation (AIF) and clinical results including extension lag of the distal interphalangeal joint for treating bony mallet finger. Methods: Forty-six patients were included with a mean follow-up of 28 months (range, 12-54 months). Twenty-seven patients were treated with EB K-wire fixation (Group A) while 19 patients were treated with AIF (Group B). We checked radiologic factors, such as amount of articular involvement, volar subluxation, mallet fragment angle, reduction loss, range of motion including extension lag, and functional outcomes using Crawford's criteria. Results: Reduction loss occurred in eight patients (17%). Differences in mean extension lag, age, preoperative volar subluxation and mallet fragment angle between patients with reduction loss and those with reduction maintaining were significant. However, there were no significant differences in gender, hand dominance, amount of articular involvement, AIF, or further flexion between reduction loss and reduction maintaining. As for patterns of displacement, there was a significant relationship between gap or step-off and extension lag. Using Crawford's evaluation criteria, functional outcomes were excellent in 31, good in 10, fair in 3, and poor in 2 patients. Conclusion: Reduction loss should be careful in older age, smaller mallet fragment angle and preoperative volar subluxation.