• Title/Summary/Keyword: Elbow method

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Proposal Methodology for Disaster Risk Analysis by Region Using RFM Model (RFM 모형을 활용한 지역별 재해 위험도 분석 방법론 제안)

  • Kim, TaeJin;Kim, SungSoo;Jeon, DaHee;Park, SangHyun
    • Journal of the Society of Disaster Information
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    • v.16 no.3
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    • pp.493-504
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    • 2020
  • Purpose: The purpose of this study is to propose an analytical methodology for selecting the priority of preventive projects in the course of carrying out disaster prevention projects that improve disaster-hazardous areas. Method: Data analysis was performed using RFM model which can divide data grade and perform target marketing based on Recency, Frequency, and Monetary. Result: The top 10% of the area with high RFM value was mainly in the East Sea and the South Sea coast, and the number of damage in private facilities was high. Conclusion: In this study, we used the RFM model to select the priority of disaster risk and to implement the regional disaster risk using GIS. These results are expected to be used as basic data for selecting priority project sites for disaster prevention projects and as basic data in the decision-making process for disaster prevention projects.

Internal Fixation with a Locking T-Plate for Proximal Humeral Fractures in Patients Aged 65 Years and Older

  • Yum, Jae-Kwang;Seong, Min-Kyu;Hong, Chi-Woon
    • Clinics in Shoulder and Elbow
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    • v.20 no.4
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    • pp.217-221
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    • 2017
  • Background: The purpose of this study was to evaluate the clinical and radiographic outcomes of internal fixation with locking T-plates for osteoporotic fractures of the proximal humerus in patients aged 65 years and older. Methods: From January 2007 through to December 2015, we recruited 47 patients aged 65 years and older with osteoporotic fractures of the proximal humerus. All fractures had been treated using open reduction and internal fixation with a locking T-plate. We classified the fractures in accordance to the Neer classification system; At the final follow-up, the indicators of clinical outcome-the range of motion of the shoulder (flexion, internal rotation, and external rotation) and the presence of postoperative complications-and the indicators of radiographic outcome-the time-to-union and the neck-shaft angle of the proximal humerus-were evaluated. The Paavolainen method was used to grade the level of radiological outcome in the patients. Results: The mean flexion was $155.0^{\circ}$ (range, $90^{\circ}-180^{\circ}$), the mean internal rotation was T8 (range, T6-L2), and the mean external rotation was $66.8^{\circ}$ (range, $30^{\circ}-80^{\circ}$). Postoperative complications, such as plate impingement, screw loosening, and varus malunion were observed in five patient. We found that all patients achieved bone union, and the mean time-to-union was 13.5 weeks of the treatment. The mean neck-shaft angle was $131.4^{\circ}$ at the 6-month follow-up. According to the Paavolainen method, "good" and "fair" radiographic results each accounted for 38 and 9 of the total patients, respectively. Conclusions: We concluded that locking T-plate fixation leads to satisfactory clinical and radiological outcomes in elderly patients with proximal humeral fractures by providing a larger surface area of contact with the fracture and a more rigid fixation.

Preventing Varus Deformity in Senile Patients with Proximal Humerus Fractures and Poor Medial Support

  • Kim, Young-Kyu;Kang, Suk-Woong;Kim, Jin-Woo
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.216-222
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    • 2016
  • Background: We investigated the effectiveness of fibular strut allograft augmentation of proximal humerus fractures to prevent varus deformity in patients over the age of 65 years with insufficient medial support. Methods: We analyzed the clinical and radiological outcomes of locking plate fixation with adjunct fibular strut allograft augmentation in 21 patients with proximal humeral fractures. The inclusion criteria were age (65-year-old or older); presence of severe medial comminution; inadequate medial support; and those who could participate in at least a one year follow-up. The average age was 76.4 years. We analyzed each patient's Constant score, our indicator of clinical outcome. As radiological parameters, we analyzed time-to-bone union; restoration of the medial hinge; difference between the immediately postoperative and the last follow-up humeral neck-shaft angles;; and anatomical reduction status, which was assessed using the Paavolainen method. Results: A successful bone union was achieved in all patients at an average of 11.4 weeks. We found that the average Constant score was 74.2, showing a satisfactory outcome. The average difference in the humeral neck-shaft angles between the immediately postoperative time-point and at the final follow-up was $3.09^{\circ}$. According to the Paavolainen method, the anatomical reduction was rated excellent. The medial hinge was restored in 14 of 21 patients. Although we did not find evidence for osteonecrosis, we found that a single patient had a postoperative complication of screw cut-out. Conclusions: Fibular strut allografting as an adjunct treatment of proximal humeral fractures may reduce varus deformity in patients with severe medial comminution.

Arthroscopic Rotator Cuff Repair : Outcome of 1 to 4 years follow up (관절경적 회전근 개 봉합술 : 1 - 4년 추시 결과)

  • Park, Jin-Young;Chung, Kyung-Tae;Meng, Ye;Park, Hee-Gon
    • Clinics in Shoulder and Elbow
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    • v.5 no.1
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    • pp.55-62
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    • 2002
  • Purpose : To compare and analyze the results of arthroscopic subacromial decompression and rotator cuff repair between partial rotator cuff tear and complete rotator cuff tear. Material and Methods : The authors studied 42 patients of rotator cuff tear with operation and followed over one year at Dankook university hospital from September, 1998 to March, 2001 The patient average age is 53 years and follow up period is 23 months (12-42mon1hs). We obtained 22 cases in the partial rotator cuff tear group and 20 cases in the complete rotator cuff tear group. In all cases, we used ASES methods to evaluated pain scale and function. Result : In the last follow up patients, the pain scale is decreased from 7.2 to 0.9 (ASES method : 34 to 91) in the partial rotator cuff tear group and from 7.6 to 1.2 (ASES method . 29 to 88) in the complete rotator cuff tear group, but there was no evidence of statistical difference between two groups (P>0.05). The range of motion after operation were increased in two groups. Excellent to good results were obtained 93% and 95% patients had pain relief and satisfied function. Conclusion : Arthroscopic subacromial decompression and arthroscopic rotator cuff repair showed good results for both of (ult-thickness and partial thickness rotator cuff tear patients in pain relief and improving the function.

Treatment of Frozen Shoulder under the Arthroscopic Capsular Release Combined with Manipulation (관절경하 관절낭 유리술과 강압교정술을 병용한 동결견의 치료)

  • You Yeun-Sik;Lee Young-Hyun;Lee Sang-Soo;Nam I1-Hyun
    • Clinics in Shoulder and Elbow
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    • v.4 no.2
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    • pp.166-172
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    • 2001
  • Purpose: To evaluate effectiveness of arthroscopic capsular release combined with manipulation in frozen shoulder. Material and Method: 15 patient who had failed to respond to physical therapy were evaluated, which were treated with arthroscopic capsular release combined with manipulation, from July 1998 to March 2000. Result: At a mean of fifteen months(range, six to twenty four) after the combined procedure, the improvement in the score of Constant and Murley averaged 45 points. The mean improvement in motion was 76 degrees for abduction; 40 degrees and 65 degrees for external rotation in adduction and abduction. Conclusion : Arthroscopic capsular release with manipulation is useful method to treatment the frozen shoulder which was not respond to conservative treatment.

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Surgical treatment of the Acute Acromioclavicular Dislocation (견봉 쇄골 관절의 급성 완전탈구에 대한 수술적 치료)

  • Lee Kwang-Won;Hwang In-Sik;Choy Won-Sik
    • Clinics in Shoulder and Elbow
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    • v.1 no.2
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    • pp.175-179
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    • 1998
  • The acromioclavicular joint is commonly affected by traumatic and degenerative conditions. Most injuries are due to direct trauma, such as a fall on the shoulder. Although there is general agreement on treatment of type I, Ⅱ, Ⅳ, V and VI acromioclavicular injuries, the treatment of type Ⅲ injuries remains controversial. Sixty patients, ranging in age from 19 to 57 years(average, 32), were evaluated an average of 57.5 (range, 13 to 96) months after surgical reconstruction for Rockwood type Ⅲ Ⅳ, V acromioclavicular dislocation. Phemister method (47 cases), Bosworth (3 cases), Weaver and Dunn method (10 cases) were used to correct displacement. An increase of the coracoclavicular distance of the injured shoulder over the normal shoulder was average 7.1㎜ at initial, average l㎜ on postoperatively, and average 2㎜ at follow-up. Overall, 54 of 60(90%) patients achieved satisfactory results. Degree of increase of the coracoclavicular distance has no inliluence to clinical results.

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Operative Treatment of the Cubital Tunnel Syndrome: Comparison of Anterior Submuscular Transposition and Anterior Subfascial Transposition of the Ulnar Nerve (주관 증후군의 수술적 치료: 척골 신경의 전방 근하 전위술과 전방 근막하 전위술의 비교)

  • Kang, Soo-Hwan;Song, Seok-Whan;Park, Il-Jung;Lee, Sang-Uk;Rhee, Seung-Koo;Park, Seung-Bum
    • Archives of Reconstructive Microsurgery
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    • v.17 no.1
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    • pp.36-41
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    • 2008
  • Surgical treatment of compressive ulnar neuropathy at the elbow has been performed with a wide variety of techniques. Among these techniques, anterior submuscular transposition of the ulnar nerve has been regarded as the method of choice by many authors. It has many advantages including a low recurrence rate, scar-free vascular bed, and protection from repeated trauma to the nerve. However, anterior submuscular transposition is technically demanding and requires more extensive soft tissue dissection. On the other hand, anterior subfascial transposition is less invasive, requires a relatively shorter operation time than the submuscular technique, and also can be done safely even in patiensts with elbow arthritis. We evaluated the clinical results of anterior submuscular transposition compared with anterior subfascial transposition. Fifteen patients underwent anterior submuscular transposition and ten patients underwent anterior subfascial transposition of the ulnar nerve. The mean follow-up time was 15 months (range 10 to 38 months) in the anterior submuscular transposition group and 7 months (range 6 to 15 months) in the anterior subfascial transposition group. According to the outcome status determination algorithm devised by Mowlavi, 3 patients (20%) showed total relief, 10 patiensts (66.7%) improvement and 2 patients (13.3%) no changes in the anterior submuscular transposition group. In the anterior subfascial transposition group, 2 patients (20%) showed total relief, 7 patients (70%) improvement and 1 patient (10%) displayed no changes. Statistically there was no significant difference of the clinical results between the two surgical techniques. Therefore we would suggest anterior subfascial transposition of the ulnar nerve as a preferred method for treatment of cubital tunnel syndrome.

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Ulnar Nerve Subluxation Diagnosed by Dynamic Ultrasonography (동적 초음파를 이용하여 진단한 주관절 척골 신경 아탈구)

  • Ji, Jong-Hun;Jung, Jae-Jung;Kim, Young-Yul;Kang, Hyun-Taek;Park, Sang-Eun;Kim, Dong-Jin
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.2
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    • pp.79-83
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    • 2010
  • Musculoskeletal ultrasonography has been used as a convenient and simple tool for diagnosis of various conditions of orthopaedic diseases for many years. Generally magnetic resonance imaging (MRI) is thought to be the best method to search for anatomical structures or variations. However, for dynamic conditions such as dislocation or subluxation of tendons and nerves, MRI is not superior to ultrasonography, especially dynamic ultrasonography. So we present such a patient with an ulnar nerve subluxation at the elbow who has symtoms mimicking cubital tunnel syndrome diagnosed by dynamic ultrasonography and treated successfully by ulnar nerve anterior transposition and think that dynamic ultrasonography is a useful method for diagnosing dynamic condition such as ulnar nerve subluxation mimicking cubital tunnel syndrome.

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Rotating Arm Internally Can Change the Arthroscopic Diagnosis of a Partial-thickness Tear of the Subscapularis

  • Kim, Hyungsuk;Song, Hyun Seok;Kang, Seung Gu;Han, Sung Bin
    • Clinics in Shoulder and Elbow
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    • v.22 no.3
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    • pp.135-138
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    • 2019
  • Background: The aims of this study were (1) to examine the footprint of the subscapularis tendon using the traditional posterior portal and $30^{\circ}$ arthroscope by simple internal rotation of the arm during surgery, and (2) to classify the pattern of a subscapularis partial-thickness tear. Methods: This study analyzed a total of 231 patients with a partial-thickness subscapularis tear from 550 consecutive patients undergoing an arthroscopic operation who had a visualization of the subscapularis tendon footprint by internal rotation of the arm. First, the patients were classified into four categories according to the tear pattern: (1) stable lamination, (2) unstable lamination, (3) avulsion, and (4) laminated avulsion. Randomized arthroscopic videos were reviewed blindly by two independent orthopedic surgeons. The pattern of the tear of the subscapularis at the neutral position and after internal rotating the arm were assessed and compared with the treatment decision (level IV case series). Results: Stable lamination, unstable lamination, avulsion, and laminated avulsion were observed in 9.1% (n=21), 20.8% (n=48), 41.1% (n=95), and 29.0% (n=67) of cases, respectively. In 145 out of 231 cases (62.8%), the decision was changed after inspecting the footprint after internal rotation of the arm, and the treatment method was changed in 116 (50.2%) cases. Conclusions: In a subscapularis tendon partial-thickness tear, inspecting the footprint of the subscapularis tendon is essential to diagnosing and deciding on the appropriate treatment. In addition, simply internal rotating the arm during surgery when using the traditional posterior portal and $30^{\circ}$ arthroscope can be a valuable method.

A Clinical Analysis of Acute Acromioclavicular Dislocation (견봉쇄골 관절탈구의 수술적 치료의 비교)

  • Kim Young Kyu;Lee Beom Koo;Moon Do Hyun;Ko Jin Hong;Lee Su Chan;Park Hong Ki;Choi Sang Kyu
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.26-34
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    • 1998
  • The management of acute acromioclavicular dislocations has usually followed the accepted principles of obtaining an anatomical reduction of the joint and maintaining it until soft tissue healing has occurred. So, the preferred treatment for acute acromioclavicular dislocation is controversial. We analysed operatively treated twenty-eight cases for acute acromioclavicular dislocation between February 1994 and January 1997 and reviewed postoperatively to evaluate the results of three different methods. We collected retrospectively the data via clinical history, associated injury, type of injury, radiographic review, Taft score, and final results. Follow up time averaged 14 months. (range, 12 to 21 ) In according to Rockwood's classification, ]7 cases were type Ⅲ, 1 case was type IV, and 10 cases were type V. Ten cases were treated with the modified Phemister method, ten cases with the modified Bosworth method and eight cases with the modified Weaver-Dunn method. ]n patients treated by modified Phemister method, the Taft score was 9.4 points and 8 cases achieved good or excellent results. In patients treated by modified Bosworth method, the Taft score was 9.8 points and 8 cases achieved good or excellent results. In patients treated by modified Weaver-Dunn method, the Taft score was 10.3 points and 7 cases achieved good or excellent results. The overall Taft score was 9.9 points and 23 cases achieved good or excellent results. There were four complications, such as calcification or metallic loosening or breakage of K-wire, but did not influence late results. In conclusions, there was no significant difference of results regarding the different three methods. However, our results indicated that the coracoclavicular ligament reconstruction by transfer of coracoacromial ligament produced better results.

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