• Title/Summary/Keyword: Functional orthopedic treatment

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Operative Treatment of Ipsilateral Fractures of Clavicle and Scapula (동측에 발생한 쇄골 골절과 견갑골 골절의 수술적 치료)

  • Park Jung Ho;Suh Seung Woo;Park Sang Won;Lee Kwang Suk
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.46-50
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    • 1998
  • The superior shoulder suspensory complex is composed of glenoid fossa, coracoid process, coracoclavicular ligament, distal clavicle, acromioclavicular ligament, acromion. Traumatic double disruptions of this complex lose its suspensory action on the shoulder joint and result in functional loss and deformity. Careful radiologic evaluation and appropriate management are required for injuries to this complex. Ipsilateral fractures of clavicle and scapula create unstable anatomic situation on shoulder joint. Conservative treatment usually fails to achieve good functional recovery due to rotator cuff weakness, nonunion, delayed union, malunion and neurovascular injury. Authors studied the result of operative treatment of ipsilateral clavicle and scapular fractures to prevent such complications. Seven cases were treated with open reduction and internal fixations of clavicle alone or clavicle and scapula simultaneously and followed up for nineteen months(twelve months - thirty-eight months). All but one patient showed good or excellent functional result according to the scoring system of Rowe. Poor result was developed in the case which had brain injury. Rigid fixations of clavicle alone or clavicle and scapular fractures both can achieve stable reduction of the fractures and prevent sequelae. We concluded that operative treatment of ipsilateral fractures of clavicle and scapula is safe and yields predictable good results.

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Primary Treatment of Acute Ankle Sprain: Retrospective Comparison of Cast Immobilization and Functional Ankle Brace (족관절 급성 염좌의 일차 치료: 석고고정과 기능적 보조기를 이용한 치료의 후향적 비교)

  • Bae, Su-Young;Ahn, Soo Hyung;Chung, Hyung-Jin;Kam, Min-Cheol
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.3
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    • pp.105-109
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    • 2019
  • Purpose: To compare the efficacy between cast immobilization and functional treatment using an ankle brace as a treatment for acute lateral ankle sprain. Materials and Methods: This study reviewed the medical records of 157 acute ankle sprain patients who were treated between 2009 and 2014. A total of 101 cases were included in this study except for cases with a combined injury, and could not be followed up for eight weeks after the first visit. The patients were divided according to the treatment modality: a cast immobilization group (64 cases) and functional treatment group (37 cases). The clinical outcomes were assessed retrospectively based on the medical records of each group. The residual symptoms, such as pain, swelling, and instability, at three weeks after the primary treatment and at the last visit were compared. Results: The residual pain and instability were significantly common in the functional treatment group at three weeks. Five cases (7.8%) of pain and one case (1.6%) of instability were in the cast group whereas nine cases (24.3%) of pain and six cases (16.2%) of instability in functional treatment group (p=0.021, p=0.014). On the other hand, there was no meaningful difference at the last follow-up. Residual pain, swelling, and instability at the last visit were noted in three (4.7%), six (9.4%), and four cases (6.3%) in the cast group, and three (8.1%), three (8.1%), and three (8.1%) were observed in the functional treatment group. Six patients refused cast immobilization. Conclusion: Although there was no significant difference at the last follow-up, cast immobilization appears to be more effective than a functional brace in terms of early pain relief and early restoration of ankle stability as a treatment for acute ankle lateral sprain in this study.

Good functional results with open reduction and internal fixation for locked posterior shoulder fracture-dislocation: a case series

  • Nicolas Moran;Michael Marsalli;Mauricio Vargas;Joaquin De la Paz;Marco Cartaya
    • Clinics in Shoulder and Elbow
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    • v.25 no.4
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    • pp.288-295
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    • 2022
  • Background: There is no standardized therapeutic strategy for locked posterior shoulder fracture-dislocation (PSFD), and no consensus exists on the analysis of preoperative factors. This retrospective study aimed to evaluate functional results and complications in a series of PSFD cases managed with open surgical treatment. Methods: Patients diagnosed with locked PSFD who underwent open surgical treatment with reduction and osteosynthesis between April 2016 and March 2020 were included. All participants were treated with open reduction and internal fixation. Functional assessment used the modified University of California, Los Angeles (UCLA) mod scale, American Shoulder and Elbow Surgeons (ASES) questionnaire, subjective shoulder value (SSV), and visual analog scale (VAS). Complications were evaluated clinically and radiologically by X-ray and computed tomography. Results: Twelve shoulders were included (11 patients; mean age, 40.6 years; range, 19- 62 years). The mean follow-up duration was 23.3 months (range, 12-63 months). The UCLA mod, ASES, SSV, and VAS scores were 29.1±3.7, 81.6±13.5, 78±14.8, and 1.2±1.4 points, respectively. The overall complication rate was 16.6%, with one case of post-traumatic stiffness, 1 case of chronic pain, and no cases of avascular necrosis. Conclusions: Open surgical treatment of locked PSFD can achieve good functional results. A correct understanding of these injuries and good preoperative planning helped us to achieve a low rate of complications.

Antegrade Intramedullary Nailing in Traumatic Humeral Shaft Fractures (외상에 의한 상완골 간부골절의 전향적 골수강내 금속정 고정술)

  • Kim, Eugene;Ahn, Hyung Sun;Choi, Young Joon;Kim, Chung Hwan;Hwang, Jae Kwang;Lee, Jong Ha
    • Journal of Trauma and Injury
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    • v.18 no.1
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    • pp.41-46
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    • 2005
  • Background: We evaluated the clinical and the radiological results of treatment for humeral shaft fractures by using an antegrade intramedullary nail. Methods: Thirty-nine (39) cases of humeral shaft fractures treated with antegrade intramedullary nail were evaluated. Bone union was evaluated with simple radiographic findings, and a functional evaluation was done using the American Shoulder and Elbow Surgeons (ASES) score. Results: The average duration until union was 14.1 weeks. On the functional evaluation using the ASES score, 15 cases were excellent, 19 cases good, 3 cases fair, and 2 cases poor. Conclusion: We conclude that antegrade intramedullary nailing has a good clinical and radiological result for treatment of humeral shaft fractures.

Effects of remedial massage therapy on the pain, grip strength and functional status scale in carpal tunnel syndrome (정형의학적 마사지가 수근관 증후군 환자의 통증, 악력, 기능적 평가의 등급에 미치는 영향)

  • Ma, Sang-Yeol;Gong, Won-Tae;Kang, Young-Suk
    • Journal of the Korean Data and Information Science Society
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    • v.20 no.1
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    • pp.97-107
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    • 2009
  • This study is to examine effects of orthopedic remedial massage therapy on the pain, grip strength and functional status scale in carpal tunnel syndrome. We selected 30 cases of carpal tunnel sydrome, which were evenly divided into two groups: experimental group and control group. We applied the same infrared and ultrasound therapy to both groups. The experimental group had additional treatment of orthopedic remedial massage therapy. For each subject, the pain, grip strength and functional status scale were measured before and after treatment, While both groups showed significant improvements after treatment, more significant effects were found in the experimental group.

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Lateral Epicondylitis: Current Concept

  • Jeon, In-Ho;Kekatpure, Aashay Laxmikant;Sun, Ji-Ho;Shim, Kyeong-Bo;Choi, Sung-Hoon;Lim, Sung-Joon;Chun, Jae-Myeung
    • Clinics in Shoulder and Elbow
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    • v.17 no.3
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    • pp.138-144
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    • 2014
  • Lateral epicondylitis is one of the most common causes of elbow pain and has been known to be caused by degeneration of the extensor carpi radialis brevis (ECRB). Nonoperative treatment should be tried first in all patients, because it has been deemed highly successful; however only few prospective studies suggest that symptoms frequently was completely resolved. Operative treatment is indicated for recalcitrant pain after failed conservative treatment, which involves excision of the pathologic portion of the ECRB and results in a high degree of subjective relief and functional restoration. We will review the pathology of the lateral epicondylitis and operative and nonoperative treatment of lateral epicondylitis.

Anterior Lateral Thigh Free Flap and Achilles Tendon Reconstruction Surgery for Contact Dermal Burn of Heel Including Achilles Tendon: A Case Report -Surgical Treatment for Functional Recovery- (아킬레스건을 포함한 뒷발굽 접촉성 피부 화상에 대해 시행한 전외측 대퇴피부 피판술 및 아킬레스건 재건술: 증례 보고 -기능적 회복을 위한 수술적 치료법-)

  • Park, Jun-Sik;Baek, Seung-Ha;Kim, Gab-Lae
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.3
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    • pp.127-130
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    • 2018
  • A 3rd degree burn on the heel including the Achilles tendon is vulnerable and requires active treatment to improve the functional outcomes. Previously, there have been a few treatments on severe burns, such as amputation, debridement or simple skin graft. The cooperative technique of an anterior lateral thigh flap with Achilles tendon reconstruction can be an innovative procedure that preserves the major arteries. The authors review a case and report the clinical outcome.

Diagnosis and Treatment of Acute Ankle Sprain (족관절 급성 염좌의 진단과 치료)

  • Byun, Chu-Hwan;Chung, Jin-Wha
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.3
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    • pp.81-85
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    • 2015
  • Acute sprain of the ankle requires comprehensive history taking and physical examination in diagnosing the type of severity and deciding on the plan of treatment. Literature supports functional treatment as the treatment of choice for grade I and II injuries. During the acute phase, the goal of treatment focuses on controlling pain and swelling. PRICE (protection, rest, ice, compression, and elevation) is a well-established protocol at this phase. There is some evidence that application of ice and use of nonsteroidal anti-inflammatory drugs improves healing and speeds recovery. Then the functional treatment (motion restoration and strengthening exercises) is administered to progress the rehabilitation appropriately in order to facilitate healing and restore the mechanical strength and proprioception. Early mobilization has been shown to result in more rapid return to work and daily activities than immobilization. Grade III injuries still generate controversy in terms of the best management available, and more studies on early mobilization, cast immobilization, or surgery are needed. Even the Cochrane reviews published to date are not conclusive.

The Effects of Interferential Current and Kaltenborn-Evjenth Orthopedic Manual Therapy on Functional Constipation

  • Koo, Ja-Pung;An, Ho-Jung;Koo, Hee-Seo;Park, Ji-Hwan;Kim, Suhn-Yeop;Kim, Yong-Kwon;Choi, Jung-Hyun;Kim, Soon-Hee;Min, Kyung-Ok
    • Journal of International Academy of Physical Therapy Research
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    • v.1 no.1
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    • pp.45-51
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    • 2010
  • 2 week study was conducted to investigate the effects of Interferential Current(IC) and Kaltenborn-Evjenth Orthopedic Manual Therapy(KEOMT) on functional constipation. Interventions were applied to spinal segments between $T_9-L_2$ which provides innervations to the gastrointestinal tract. Subjects(n=24) were randomly allocated to two treatment groups: the IC group or the KEOMT group. Results for the IC therapy demonstrated significant decrease with the colonic transit time(CTT) as well as scores on the constipation assessment scale(CAS). The frequency of defecations per week had increased significantly(p<0.05). The KEOMT displayed decreased CTT in the left colon region. The scores on the CAS were reduced and frequency of defecations per week had increased significantly (p<0.05). This study not only showed that both modes of therapy improved symptoms of constipation, but also optimized gastrointesti. nal content movement, eventuating in a more normalized CTT. In conclusion, both the IC therapy and the Kaltenborn-Evjenth Orthopedic Manual Therapy have shown to be effective interventions for improving functional constipation.

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Intramedullary Nailing versus Minimally Invasive Plate Osteosynthesis for Distal Tibia Shaft Fractures: Retrospective Comparison of Functional and Cosmetic Outcomes (경골 원위간부 골절 치료의 골수강내 금속정 고정술과 최소침습 금속판 고정술의 비교: 기능적, 미용적 결과의 후향적 비교)

  • Kahyun Kim;In Hee Kim;Geon Jung Kim;SungJoon Lim;Ji Young Yoon;Jong Won Kim;Yong Min Kim
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.3
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    • pp.93-98
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    • 2023
  • Purpose: This study compared the functional and cosmetic treatment outcomes of intramedullary nailing (IM nail) and minimally invasive plate osteosynthesis (MIPO) for distal tibia shaft fractures. Materials and Methods: Forty-eight patients with distal tibia shaft fractures (distal 1/3 of the diaphysis, AO/OTA [AO Foundation/Orthopaedic Trauma Association]) 43 managed by an IM nail (n=30) or MIPO (n=18) who had minimum one-year follow-up were enrolled in this study. The radiological, functional, and cosmetic outcomes in the two groups were compared retrospectively. Results: All patients achieved bone union. The mean bone union time of the IM nail and MIPO groups was 18.5 and 22.6 weeks, respectively (p=0.078). One patient in the MIPO group showed posterior angulation and valgus deformity of more than five degrees. The mean American Orthopaedic Foot and Ankle Society (AOFAS) functional scores were similar: 83.3 in the IM nail group and 84.6 in the MIPO group (p=0.289). The most salient difference was the cosmetic result of the surgical scar. The length of the scars around the ankle in the IM nail group was significantly smaller than the MIPO group (2.6 cm vs. 10.6 cm; p=0.035). The patient satisfaction survey of surgical scars revealed a significantly higher satisfaction rate in the IM nail group than in the MIPO group (93% vs. 44%; p<0.001). Conclusion: This study showed that both treatment methods for distal tibia shaft fractures have similar therapeutic efficacy regarding the radiological and functional outcomes. On the other hand, the IM nail technique showed superior cosmetic outcomes than the MIPO technique. IM nails may be more recommended in patients with high demand for cosmetic results.