• Title/Summary/Keyword: Clinical scoring system

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The Function and Symptoms of Ankle Joint in the Distal Tibial Fractures Treated by Nailing (족관절 기능과 증상을 중심으로 평가한 경골 원위부 골절에서의 금속정 치료 결과)

  • Kim, Byoung-Min;Bae, Su-Young;Roh, Jae-Young
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.1
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    • pp.86-92
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    • 2008
  • Purpose: To evaluate the safety and prognostic factors of intramedullary nailing of distal tibia fractures in terms of function and symptoms of the ankle joint. Materials and Methods: We retrospectively analyzed 22 distal tibial fractures with intramedullary nailing. The mean duration of follow-up was 43 months. We reviewed medical records to describe each case. We measured radiographic parameters such as fracture configuration, arthritic change of the ankle joint and status of reduction. We also assessed clinical results by AOFAS ankle hind foot scoring system, degree of pain by VAS and range of motion to find out prognostic factors for functional result of the ankle joint. Results: Bone healing was obtained in all cases without any wound complications. Mean AOFAS ankle score was 94. There were 4 cases with mild (VAS<3/10) ankle pain and 2 cases with mild limitation of ankle motion. The comminution of fracture had a significant relationship with delayed angular deformity of ankle joint (p=0.032). There was no other significant parameter affecting ankle joint function except the location of nail-end. Conclusion: Intramedullary nailing in distal tibia fracture is a safe and effective procedure. But further study may need to evaluate the relationship between the position of nail-end and the function of ankle joint.

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Comparison of Antiglide Plate Fixation and Lateral Plate Fixation for Danis-Weber Type B Isolated Lateral Malleolar Fractures (족관절 외과의 Danis-Weber B형 단독 골절에 있어서 활주 방지 금속판고정술과 외측 금속판고정술의 비교)

  • Ha, Joong-Won;Kim, Hyoung-Bok;Ko, Min-Suk;Yoon, Han-Kook
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.3
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    • pp.153-158
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    • 2011
  • Purpose: This study was performed retrospectively and to compare the clinical outcomes of the surgical management using Antiglide plating and lateral plating for Danis-Weber type B isolated lateral malleolar fractures. Materials and Methods: Between March 2004 and March 2009, 92 patients were followed up for more than 6 months after surgical treatment. 49 patients were treated with Antiglide plating, whereas the remaining 43 patients underwent lateral plating. The results of the two groups were analyzed both radiographically and clinically using Ankle scoring system. Results: Both groups were comparable for age, sex distribution, time to surgery, and operation time. Bone union was noted at average of 8 weeks in all fractures. The mean ankle score was similar in both groups (94% versus 93%). Conclusion: Antiglide plating for Danis-Weber type B isolated lateral malleolar fracture is one of the good methods which has some advantages such as early ankle motion, ambulation and smaller operative incision.

Operative Treatment of Fractures of the Fifth Metatarsal Base (제5 중족골 기저부 골절의 수술적 치료)

  • Suh, Jin-Soo;Kim, Jung-Hoon;Choi, Jun-Young
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.189-196
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    • 2008
  • Purpose: Nonunions and delayed unions are possible complications of fractures of fifth metatarsal base. We tried to report the results of the surgical treatment, which is not prevalent yet. Materials and Methods: Retrospective study of thirty nine patients undergoing operation at our institution between 2003 and 2008 was conducted. Six patients were excluded with loss of follow up before bony union, multiple trauma, pediatric fractures, stress fracture, open fracture. There were 18 males and 15 females with 45.1 years old mean age. The average follow-up period was 18.3 months. We used a midfoot scoring system of AOFAS for clinical assessment and radiologic findings to evaluate bony union, alignment. Results: According to Lawrence's classification, Zone 1 fractures were thirteen and Zone 2 were twenty. Average AOFAS score was 93.61. Conclusion: Early operative treatment with cannulated screw fixation in fractures of the fifth metatarsal base is thought to be an useful and easy treatment option with faster rates of union.

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Comparison of the Usefulness of MDCT (Multidetective Computed Tomogram) in Facial Bone Fractures (안면부 골절 수술 전후 다중검출기 전산화 단층촬영의 효용성 비교)

  • Hong, Yoon Gi;Kim, Hyung Taek
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.28-34
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    • 2006
  • Purpose: In maxillofacial surgery, proper preoperative diagnosis is very important in achieving good postoperative results. Although conventional CT scans are useful for visual representations of fractures, they cannot provide direct guidance for reconstructing facial bone fractures. However, the recent technology of multislice scanning has brought many clinical benefits to CT images. Direct correlations can be made between preoperative imaging data and operative planning. The aim of the current study is to evaluate the differences between conventional CT and multidetective three-dimensional CT(3D MDCT) measurements in craniofacial deformities. Methods: From January 2005 to November 2005, MDCT scans of 41 patients were evaluated by comparing them with conventional CT scans. The 3D MDCT images were assessed and reviewed by using a simple scoring system. Results: The 3D MDCT scans offered easy interpretation, facilitated surgical planning, and clarified postoperative results in malar complex fractures, mandibular fractures, and extensive maxillofacial fractures and cranioplasty. However, 3D MDCT images were not superior to conventional CT scans in the diagnosis of blowout fractures. Conclusion: In spite of its limitations, the 3D MDCT provided additional and more comprehensive information than the conventional CT for preoperative assessment of craniofacial deformities. Therefore, the 3D MDCT can be a useful tool for diagnosis and systematic treatment planning in craniofacial skeletal deformities.

A Clinical Study on Liver Scanning using Colloidal Radiogold and Liver Function in Cirrhosis of the Liver (간경변증(肝硬變症)에 있어서 교질형방사성금(膠質形放射性金)($^{198}Au$)을 사용(使用)한 간(肝)스켄과 간기능(肝機能)과의 관계(關係)에 관(關)한 임상연구(臨床硏究))

  • Koh, Chang-Soon;Rhee, Chong-Heon;Chang, Ko-Chang;Lee, Young;Min, Young-Eal;Hong, Changgi D.
    • The Korean Journal of Nuclear Medicine
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    • v.3 no.1
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    • pp.59-67
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    • 1969
  • Correlation between the blood clearance half time and findings of liver scan using the colloidal radiogold in patients of liver cirrhosis is observed through the scoring system, in which the more changes in size, shape and density in the liver scan, the more points are given (table 1). Results: 1) Within the increase in severity of hepatocellular dysfunction in liver cirrhosis, the degree and frequency of following changes in liver scan (done with colloidal radiogold) were increased in order. a) generalized hepatomegaly b) enlargement of the left lobe & reduction of the right lobe c) relatively increased radiodensity in the left lobe and 4) visualization of spleen. 2) Frequency of the normal scan in liver cirrhosis was $12{\pm}3.56%$, frequency of normal value in blood clearance half time of the radiogold was $5.0{\pm}2.34%$ and frequency of normal scan & normal blood clearance rate in liver cirrhosis was $3.6{\pm}2.06%$.

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Effect of Neurodynamics on Pain and Paresthesia in Post-operated Patients with Lumbar Disc Herniation

  • Jang, Ki-ryong;Park, Ji-Won;Nam, Kiseok
    • The Journal of Korean Physical Therapy
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    • v.32 no.2
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    • pp.80-87
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    • 2020
  • Purpose: Some patients who have undergone surgery due to lumbar disc herniation still complain of leg pain and other abnormal sensations. Therefore, the study examined the effects of the neurodynamics on pain and other abnormal nerve sensations in post-operated patients with lumbar disc herniation. Methods: The participants of this study comprised 20 adults (10 males and 10 females) who were diagnosed with lumbar disc herniation. The subjects were classified into two groups of 10 patients each in the lower extremity neurodynamics (LEN) and lumbar stabilization exercise (LSE) groups. Each intervention was applied twice a day for one week and was composed of two different exercise patterns; one was applied by a therapist, and the other was performed by the patients themselves. The data were analyzed using assessment methods of Digital Infrared Thermal Imaging (DITI), Toronto clinical neuropathy scoring system (TCNSS), Sympathetic Skin Response (SSR) test, and Oswestry Disability Index (ODI) scale. Results: Significant differences in TCNSS, DITI, ODI scale were observed between the LEN and LSE group (p<0.01). On the other hand, there was no significant difference in the SSR test between pre and post-treatment (p>0.05). Conclusion: The results indicated that neurodynamics treatment is effective in pain reduction and abnormal sensations, such as leg muscle cramps, in post-operated patients with lumbar disc herniation.

Arthroscopic Bridging Repair Using Human Dermis Allografts for Irreparable Rotator Cuff Tears

  • Jeong, Ju Seon;Kim, Moo-Won;Kim, In Bo
    • Clinics in Shoulder and Elbow
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    • v.19 no.2
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    • pp.84-89
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    • 2016
  • Background: The purpose of this study was to assess the results of arthroscopic bridging repair using a human dermis allograft in the treatment of massive irreparable rotator cuff tears. Methods: From November 2009 to April 2011, 12 patients underwent arthroscopic bridging repair using a human dermis allograft in the treatment of massive irreparable rotator cuff tears. Patients were followed for an average of 33.9 months. Clinical outcome was evaluated preoperatively and postoperatively using the mean University of California, Los Angeles (UCLA) score and the Korean Shoulder Scoring System (KSS). Magnetic resonance imaging (MRI) was performed postoperatively at an average of 6.5 months. Results: At a mean follow-up of 33.9 months (range, 25 to 42 months), 11 out of 12 patients were satisfied with their procedure. Patients showed significant improvement in their mean modified UCLA score from 15.9 preoperatively to 29.4 postoperatively (p=0.001). The mean KSS score improved from 45.6 preoperatively to 80.5 postoperatively (p=0.002). In MRI studies, 9 out of 12 patients had full incorporation of the graft into the native rotator cuff remnant. To date, there has been no intraoperative or postoperative complication from the graft procedure, such as infection or allograft rejection, in any patient. Conclusions: Arthroscopic bridging repair using a human dermis allograft can be considered as an option in treatment of select cases of massive irreparable rotator cuff tears, resulting in high patient satisfaction.

Healing outcomes of root canal treatment for C-shaped mandibular second molars: a retrospective analysis

  • Ahn, Hye-Ra;Moon, Young-Mi;Hong, Sung-Ok;Seo, Min-Seock
    • Restorative Dentistry and Endodontics
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    • v.41 no.4
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    • pp.262-270
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    • 2016
  • Objectives: This study aimed to evaluate the healing rate of non-surgical endodontic treatment between C-shaped and non-C-shaped mandibular second molars. Materials and Methods: Clinical records and radiological images of patients who had undergone endodontic treatment on mandibular second molars between 2007 and 2014 were screened. The periapical index scoring system was applied to compare healing outcomes. Information about preoperative and postoperative factors as well as the demographic data of the patients was acquired and evaluated using chi-square and multinomial logistic regression tests. Results: The total healing rate was 68.4%. Healing rates for the mandibular second molar were 70.9% in C-shaped canals (n = 79) and 66.6% in non-C-shaped ones (n = 117). The difference was not statistically significant. Conclusions: The presence of a C-shaped canal in the mandibular second molar did not have a significantly negative effect on healing after treatment. Instead, proper pulpal diagnosis and final restoration were indicated as having significantly greater influence on the healing outcomes of C-shaped and non-C-shaped canals, respectively.

Predisposing Factors and Treatment for the Fifth Proximal Metatarsal Fracture (제5 중족골 기저부 골절의 유발인자 및 치료)

  • Shin, Hun-Kyu;Choi, Jae-Yeol;Lee, Ji-Won
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.67-71
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    • 2007
  • Purpose: To evaluate clinical results of the 5th proximal metatarsal intraarticular fracture (Zone I) with displacement treated operatively and to evaluate predisposing factors of the 5th proximal metatarsal fracture (Zone I). Materials and Methods: 11 patients treated for the 5th proximal metatarsal fracture (Zone I) operatively and 10 patients treated conservatively between Jan 2003 and Dec 2005, were followed for more than one year. Functions were graded by AOFAS foot scoring system and union time and postoperative complications were also evaluated. Calcaneal pitch angle was also evaluated. Results: Clinically there were no much difference in results. Clinical points were 94.5 in the operative group and 92.3 in the conservative group. At the last follow-up, the radiographic results showed union in all cases. During the follow-up period, there were no significant complications. But in the conservative group, displaced fracture with calcaneal pitch angle over 30 degree tends to show delayed union and time to loss of pain tends to be prolonged. Conclusion: Calcaneal pitch angle is thought to predisposing factor for 5th metatarsal base fracture. Operative treatment is viable option for the 5th proximal metatarsal intraarticular fracture with displacement and with calcaneal pitch angle over 30 degree. In cases of cavovarus foot deformity, we think operative treatment should be considered with deliberation and long term follow-up study for peroneal tendinopathy should be needed.

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Treatment of Multidirectional Instability of the Shoulder with Inferior Capsular Shift (하방 관절낭 이동술을 이용한 다방향 견관절 불안정의 치료)

  • Lee Byoung Chang;Chun Churl Hong;Park Seong Kyu
    • Clinics in Shoulder and Elbow
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    • v.3 no.2
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    • pp.79-86
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    • 2000
  • Purpose: We analysed the clinical efficacy of inferior capsular shift operation in multidirectional instability of the shoulder joint in terms of functional aspects and patient's satisfaction Materials and Methods: From July, 1998 to March, 2000, we treated 23 cases of multidirectional instability of the shoulder joint with T-shaped inferior capsular shift and/or Bankart repair. All of them have complained of an experience about frank dislocations. Two of them has a voluntary component. We evaluated them according to complication, function, range of motion, stability and patient's satisfaction with an average follow-up of 15 months(the range of 9 to 27 months). Results: Eight cases were atraumatic multidirectional instability and coexisting Bankart lesion were present in 15. There was no redislocation, but one case of symptomatic subluxation, 3 cases of transient nerve palsy and 2 cases of feeling of laxity developed. Limitation of motion after surgery was an average of 3.4° in flexion, and 8.5° in external rotation. With Rowe scoring system, the clinical result was excellent or good in 22 cases and poor in one. According to American shoulder and elbow society, pain score improved to 1.4 from 6.1, and stability score also improved to 1.8 from 9.1. Conclusion: In multidirectional shoulder instability, one should pay attention to finding a coexisting Bankart lesion. In that case, adequate capsular volume reduction by using inferior capsular shift as well as repair of Bankart lesion is needed to get a good surgical outcome.

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