• Title/Summary/Keyword: Clavicle

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Surgical Treatment for Acute Acromioclavicular Joint Dislocation (급성 견봉쇄골관절 탈구의 수술적 치료)

  • Kim Jeong Hwan;Kim Chong Kwan;Lee Saeng Guk;Kim Young O;Park Jae Kyu;Yoon Jong Ho
    • Clinics in Shoulder and Elbow
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    • v.4 no.1
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    • pp.17-23
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    • 2001
  • There has been considerable controversy concerning the methods for treatment of dislocation of the acromioclavicular joint, especially in grade III injury. The authors have treated 24 cases of the complete dislocation of the acromioclavicular joint from January 1990 to July 2000. We performed 14 cases of coracoclavicular wiring operation, 10 cases of modified Phemister operation and compared the results and complication of wiring operation with modified Phemister. The clinical results in modified phemister operation were excellent in 8 cases(80%), good in 1 case(l0%), fair 1 case(10%). In wiring operation, excellent is 11 case(78%), good is 2 case(14%), fair is 1 case(14%). The complications of modified Phemister operation were breakage and migration of K-wire in 2 cases. In wiring operation, breakage of wire was in 2 cases but migration was not showed. We prefered coracoclavicular wiring operation for dislocation of acromioclavicular joint of active young adults because of the following advantages: 1) violation of acromioclavicular joint can be avoided but rotation of the clavicle was not restricted. 2) The operation is simple to perform. 3) Postoperative immobilization is minimal. 4) Removal of the wire is easy because wire was not migrated when breakage of wire was occured.

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Arthroscopic Treatment of Acute Acromioclavicular Dislocation using $TightRope^{(R)}$ ($TightRope^{(R)}$를 이용한 관절경적 급성 견봉쇄골 관절 탈구의 치료)

  • Kim, In-Bo;Shon, Myung-Hwan;Kim, Moon-Chan;Kim, Dong-Jun
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.1
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    • pp.13-18
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    • 2011
  • Purpose: The purpose of this study is to evaluate the radiologic and clinical results of the arthroscopic coracoclavicular fixation of the acute acromioclavicular dislocation using $TightRope^{(R)}$ (Arthrex, Inc, Naples, FL). Materials and Methods: We performed the arthroscopic coracoclavicular fixation using $TightRope^{(R)}$ in twenty patients with the Rockwood type III or V acute acromioclavicular dislocation between February, 2009, and February, 2010. Mean follow-up was 13.4(range 8~22) months. Radiologic results were evaluated by comparing the distances between the clavicle and the coracoid process with those in the contralateral sides using the acromioclavicular stress radiographs. Clinical results were made according to the KSS(Korean Shoulder Scoring System), and the cosmetic satisfaction of the patient was assessed. Results: Radiologically, 18 cases showed excellent, 1 case showed good and 1 case showed fair results. Clinically, KSS was mean 98.5 (range 92~100) points and all cases revealed satisfactory cosmetic results. Because one case complained of skin tenderness and discomfort of palpation, we closed the knot with surrounding muscle & fascia. Then local wound infection occurred, so we treated it by incision and drainage under local anesthesia and antibiotic therapy for 2 weeks. Conclusion: Arthroscopic coracoclavicular fixation using $TightRope^{(R)}$ for treating the Rockwood type III or V acute acromioclavicular dislocation showed satisfactory radiologic and clinical results. It seems to be a good treatment method that has little postoperative complication, provides an early rehabilitation and an excellent cosmetic result, and does not require secondary operation for removal of metal implant.

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Treatment of Subclavian Artery Injury in Multiple Trauma Patients by Using an Endovascular Approach: Two Cases (다발성 외상환자에서 혈관계 접근을 통해 치료한 쇄골하동맥 손상 2례)

  • Cho, Jayun;Jung, Heekyung;Kim, Hyung-Kee;Lim, Kyoung Hoon;Park, Jinyoung;Huh, Seung
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.243-247
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    • 2013
  • Introduction: Surgical treatment of subclavian artery (SA) injury is challenging because approaching the lesion directly and clamping the proximal artery is difficult. This can be overcome by using an endovascular technique. Case 1: A 37-year-old male was drawn into the concrete mixer truck. He had a right SA injury with multiple traumatic injuries: an open fracture of the right leg with posterior tibial artery (PTA) injury, a right hemothorax, and fractures of the clavicle, scapula, ribs, cervical spine and nasal bone. The injury severity score (ISS) was 27. Computed tomography (CT) showed a 30-mm-length thrombotic occlusion in the right SA, which was 15 mm distal to the vertebral artery (VA). A self-expandable stent($8mm{\times}40mm$ in size) was deployed through the right femoral artery while preserving VA flow, and the radial pulse was palpable after deployment. Other operations were performed sequentially. He had a viable right arm during a 13-month follow-up period. Case 2: A 25-year-old male was admitted to our hospital due to a motorcycle accident. The ISS was 34 because of a hemothorax and open fractures of the mandible and the left hand. Intraoperative angiography was done through a right femoral artery puncture. Contrast extravasation of the SA was detected just outside the left rib cage. After balloon catheter had been inflated just proximal to the bleeding site, direct surgical exploration was performed through infraclavicular skin incision. The transected SA was identified, and an interposition graft was performed using a saphenous vein graft. Other operations were performed sequentially. He had a viable left arm during a 15-month follow-up period. Conclusion: The challenge of repairing an SA injury can be overcome by using an endovascular approach.

Morphological Changes During Starvation in Early Developmental Stages of Spotted Sea Bass, Lateorabrax sp. I. Post-larval Stage (점농어 Lateorabrax sp. 초기 발육 단계에 있어서의 기아시 형태 변화-I. 후기 자어기)

  • Myoung, Jung-Goo;Park, Chul-Won;Kim, Min-Suk;Kim, Jong-Man;Kang, Chung-Bae;Kim, Yong-Uk
    • Korean Journal of Ichthyology
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    • v.9 no.1
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    • pp.15-21
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    • 1997
  • The influence of delayed(1, 2, 3, 4 days) feeding and starvation on morphological change and survival rate of the spotted sea bass larvae was examined at the KORDI laboratories which located at Poryong Power Plant, Poryong-gun, Chungchongnam-do in November, 1996. 1. The larvae of spotted sea bass began to feed on rotifers at 5 days after hatching. In case of non-feeding, all of the larvae died at 9 days after hatching. The larvae which fed 1 day after the normal first feeding schedule(1 day delayed) grew normally and 2 days delayed groups showed 5.3% in survival rate at 9 days after hatching. In case of non-feeding and 3 or 4 days delayed groups, all of the larvae died between 9 and 10 days after hatching. 2. In case of non-feeding, total length of the larvae decreased gradually. 3. The percente ratio of gut height and mytome height to standard length in starved larvae has declined most rapidly compare to other demensions during the non-feeding period. The percente ratio of gut height to mytome height had also difference between unfed and fed larvae. At 9 days after hatching, the ratio of that between fed and unfed larvae were 84.5 % and 52.4 %, respectively. 4. The morphology of starving larvae were characterized as sharpened jaw, projected edge of lower part of clavicle and bending trunk with slenger gut.

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Two Cases of Fractured and Embolized Implanted Central Venous Chemoports in Lung Cancer (폐암환자에서 발생한 피하매몰 중심정맥포트 골절 및 색전증 2예)

  • Ju, Jin Yung;Cho, Jae Yeong;Lim, Jung Hwan;Cho, Gye Jung;Chae, Dong Ryeol;Oh, In Jae;Kim, Kyu Sik;Kim, Yu Il;Lim, Sung Chul;Kim, Young Chul;Song, Sang Yoon;Na, Kook Ju;Kim, Yun Hyun;Kim, Jae Kyu
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.5
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    • pp.449-453
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    • 2007
  • Totally implanted central venous access devices for chemotherapy (chemoport) are being used increasingly in lung cancer patients. Vascular catheters are associated with various complications including infection, thrombosis as well as spontaneous fractures and embolization of the catheter, which is known as 'pinch-off syndrome'. 'Pinch-off syndrome' refers to the compression of a subclavian central venous catheter between the clavicle and first rib resulting in an intermittent or permanent obstruction, which can lead to tears, transection, or embolization. We report two cases of fractured and embolized implanted subclavian venous catheters in which the fragments were removed percutaneously. A 62-year-old man presented with back pain with a duration of a few weeks. The chest radiograph revealed complete transsection and embolization of the catheter into the right atrium. In addition, a 47-year-old woman with a chemoport had a grade 3 pinch-off sign in a chest radiograph demonstrating complete transsection and embolization of the catheter into the pulmonary artery. Both cases were managed by retrieving the embolized distal fragment percutaneously and removing the proximal section of the catheter.

A Novel RUNX2 Mutation in a Korean Family with Cleidocranial Dysplasia (한국인 쇄골 두개 이형성증 가족에서의 RUNX2 유전자 돌연변이)

  • Lee, Ji Won;Song, Jisoo;Shin, Teo Jeon;Hyun, Hong-Keun;Kim, Young-Jae;Lee, Sang-Hoon;Kim, Jongbin;Kim, Jung-Wook
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.4
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    • pp.409-415
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    • 2019
  • Cleidocranial dysplasia (CCD) is an autosomal-dominant disease characterized by the delayed closure of cranial sutures, defects in clavicle formation, supernumerary teeth, and delayed tooth eruption. Defects in the Runt-related transcription factor 2 (RUNX2), a master regulator of bone formation, have been identified in CCD patients. The aim of this study was to identify the molecular genetic causes in a CCD family with delayed tooth eruption. The 23-year-old female proband and her mother underwent clinical and radiographic examinations, and all coding exons of the RUNX2 were sequenced. Mutational analysis revealed a single nucleotide deletion mutation (NM_001024630.4 : c.357delC) in exon 3 in the proband and her mother. The single C deletion would result in a frameshift in translation and introduce a premature stop codon [p.(Asn120Thrfs*24)]. This would result in the impaired function of RUNX2 protein, which may be the cause of delayed eruption of permanent teeth in the family.

Surgical Treatment of Metastatic Pathologic or Impending Pathologic Fractures (전이성 병적 골절 또는 병적 임박 골절의 수술적 치료)

  • Kim, Kap-Jung;Lee, Sang-Ki;Choy, Won-Sik;Seo, Dong-Wook
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.44-51
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    • 2009
  • Purpose: We evaluated the results of surgical treatment for metastatic pathologic or impending pathologic fractures. Materials and Methods: From January 2004 to December 2007, 18 patients 19 cases were included. Male were 6 and female were 12. The mean age was 65.1. Mean follow up period was 15.2 months. Pathologic fractures were 14 and impending pathologic fractures were 5. MSTS score, periodic radiologic follow up and postoperative complications were evaluated. Results: The primary malignancies were 6 cases of multiple myeloma, 4 cases of renal cell carcinoma, 2 cases of cholangiocarcinoma, 2 cases of colon cancer, 2 cases of breast cancer and 2 cases of leiomyosarcoma. Metastatic lesions were 10 cases of femur, 4 cases of clavicle, 2 cases of humerus, 2 cases of tibia and 1 case of radius. Surgical options were curettage, cementation, internal fixation and arthroplasty. Mean MSTS score was 15.9. Postoperative complications were 1 case of infection, 1 case of local recurrence and 1 case of implant loosening. Ten patients were alive with disease, 8 patients died of disease. Conclusion: Surgical treatment of metastatic skeletal lesions allowed early ambulation and improving dexterity. It improved pain and emotional acceptance. Surgery is necessary for improving qualities of remaining lives.

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Treatment of the Acromioclavicular Joint Dislocation Using a AO Hook Plate (AO Hook 금속판을 이용한 견봉쇄골 관절 탈구의 치료)

  • Lee, Ki-Won;Choi, Young-Joon;Ahn, Hyung-Sun;Kim, Chung-Hwan;Hwang, Jae-Kwang;Han, Hee-Don;Kim, Jae-Hyoun;Joo, Youn-Suk
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.167-172
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    • 2009
  • Purpose: We wanted to evaluate the results of treating acromioclavicular joint dislocation using an AO hook plate. Materials and Methods: Between February 2008 and September 2009, 10 patients underwent implant removal after surgical treatment of acromioclavicular joint dislocation using a AO hook plate. The Constant-Murley scoring system was administered postoperatively for evaluating the clinical results, and simple X-ray was taken for evaluating the state of reduction. Results: All cases showed satisfactory results on the clinical and radiological study. The mean Constant-Murley score at follow-up was 90.5 (range: 84~95). Three patients had some degree of discomfort with the hook plate, but these symptoms were relieved on removal of the plate. The radiological evaluation showed restoration of the vertical displacement of the clavicle in all the patients. No complications occurred such as infection, plate failure or redislocation after removal of the plate. Conclusion: The short term follow-up results of treating acromioclvicular joint dislocation using an AO hook plate were satisfactory both clinically and radiologically.

Injury Analysis of a 25-passenger Bus Left-quarter Turn Rollover Accident (25인승 버스 전복사고의 탑승자 손상 분석)

  • Park, Sang Min;Kim, Sang Chul;Lee, Kang Hyun;Lee, Jae Wan;Jeon, Hyuk Jin;Kim, Ho Jung;Kim, Jin Yong;Kwak, Young Soo;Lee, Woo Sung
    • Journal of Trauma and Injury
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    • v.27 no.3
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    • pp.50-56
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    • 2014
  • Purpose: Rollover motor vehicle crashes have a higher injury severity and fatality than other motor vehicle crash types. From a left-quarter turn rollover accident of 25-passenger bus, we intend to assess the injury of the occupant and the injury severities according to the occupants' position. Methods: We carried out the 3 steps investigation of occupants' interview, visiting the repair shop and using the police report. We analyzed injuries sustained by occupants, and compared injury severities considering column, row in occupant's position and passenger interaction Results: The rollover involved 14 passengers in the bus who were all old women except a man driver. The most common injury was in the upper extremity, with six occurrences being a left clavicle fracture. Major injuries including hemothorax and pneumothorax were diagnosed at left side of the occupant. In the comparison of injury severity among driver's column (left side), mid column and passengercolumn, ISS of passenger column was the highest ($9.9{\pm}7.4$, $8.8{\pm}5.5$, and $10.3{\pm}4.0$, respectively, p>0.05). The injury severity of multiple occupants by row was higher than that of single occupant (10.8 vs. 3, p<0.05). Conclusion: An occupant must fasten their seat belt to prevent an injury by passenger interaction in the left-quarter turn rollover accident of a bus.

Protective Effects of Korean Garlic Juice against the Toxicity of Methyl Mercuric Chloride (MMC) in Relation to Fetal Ossification in Pregnant Fischer-344 Rats (유기수은 노출로 인한 흰쥐 태자골격성장 지연에 대한 마늘의 보호효과)

  • Lee, Jin-Heon;Park, Kyung-Lyoul;Kim, Dae-Seon
    • Journal of Environmental Health Sciences
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    • v.34 no.2
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    • pp.161-169
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    • 2008
  • This study evaluates the protective effects of Korean garlic juice against the toxicity of methyl mercuric chloride (MMC) in relation to fetal ossification in pregnant Fischer 344 rats. This study has as its basis, both theory and data that neutral amino acids in garlic juice have protective effects against mercury poisoning. Pregnant rats were dosed in various combination with 20 mg MMC/kg body wt. and 0.5 or 1.0 garlic juice/kg body wt. on the 7th day of gestation. Fetuses were extracted from the dams on 20th day of gestation, and the fetal bones were stained and measured. The results obtained are as follows: 1. Fetal body weights, body lengths, and head length were significantly decreased by as much as 23.5%, 21.3%, 15.5% respectively in 20 mg/wt kg methyl mercuric chloride groups (p<0.05). But in the garlic treated groups, they were almost similar to the controls. 2. The ossification centers were significantly decreased by as much as 35.1% in pelvic phalanges, 53.5% in pectoral phalanges, 74.1% in ternebrae, 76.2% in tail in 20 mg/wt kg methyl mercuric chloride groups (p<0.05). But in the garlic treated groups, they were significantly increased by as much as $81.2{\sim}88.7%$ and $94.8{\sim}98.9%$ of controls. 3. The ossified pectoral girdles were significantly decreased by as much as 66.6% in clavicle, and in other areas $74.2{\sim}87.4%$ in the 20 mg/wt kg methyl mercuric chloride groups (p<0.05). But in the garlic treated groups, they were significantly increased by as much as $81.2{\sim}88.7%$ and $94.8{\sim}98.9%$ of the controls. 4. The ossified pelvic girdles were significantly decreased by as much as 57.1% and 56.1% in two ischium, $67.2{\sim}81.7%$ in metacarpals in the 20 mg/wt kg methyl mercuric chloride groups (p<0.05). But in the garlic treated groups, they were significantly increased by as much as $67.0{\sim}85.6%$ and $90.1{\sim}98.7%$ of the controls. 5. The ossified terenebrae were unchanged or significantly decreased; 0.0% in 5th, 54.1% in 1st, 83.9% in 2nd, 75.0% in 3rd, 72.7% in 4th, 79.8% in 6th of 20 mg/wt kg methyl mercuric chloride groups (p<0.05). But in the garlic treated groups, they were significantly increased by as much as $29.5{\sim}55.1%$ and $54.5{\sim}84.0%$ of the controls. 6. The ossified ribs were significantly decreased by as much as $8.3{\sim}18.0%$ in 20 mg/wt kg methyl mercuric chloride groups (p<0.05). But in the garlic treated groups, they were significantly increased by as much as $87.1{\sim}93.5%$ and $96.3{\sim}99.7%$ of the controls. In conclusion, Korean garlic juice significantly protected against the toxicity of MMC in relation to the fetal ossification in pregnant rats.