• Title/Summary/Keyword: Intraarticular injuries

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5th MTP Joint Reconstruction with Autogenic Costal Osteochondral Graft (자가늑골연골이식을 이용한 제 5중족족지관절재건술)

  • Park, Jae-Yong;Kang, Hwa-Jun
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.2
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    • pp.154-160
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    • 2013
  • The treatment of open, traumatic intraarticular injuries to the metatarsophalangeal joint with severe articular comminution and cartilage defect of metatarsal head is a challenge to the foot surgeon. We report the joint reconstruction treating the injured joint by autogenic costal osteochondral graft with satisfactory outcome.

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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The characteristic features of traumatic anterior shoulder instability due to an event of minor trauma

  • Mura, Nariyuki;Goto, Yasuo;Momonoi, Yoshiyuki;Takei, Isao;Tsuruta, Daisaku;Sasaki, Jyunya;Harada, Mikio;Ogino, Toshihiko
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2009.03a
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    • pp.21-21
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    • 2009
  • There are some patients who have traumatic anterior shoulder instability due to minor injuries like overhead activities. The purpose of this study was to clarify characteristic features of traumatic anterior shoulder instability due to minor injuries. According to the mechanism of injury in an initial dislocation, 83 shoulders that underwent the stabilizing surgery for traumatic anterior shoulder instability were divided into two groups. Traumatic group included patients who suffered from a fall or a direct injury. Minor injury group included patients who suffered from the other injury like overhead activity. General joint laxity, range of motion and laxity under anesthesia, and intraarticular findings were compared between two groups. The morphology of superior and middle glenohumeral ligaments, Bankart lesion, Hill-Sachs lesion, and partial articular surface tendon avulsion lesion were observed in arthroscopy. Minor injury group consisted of 19 shoulders with 8 males, 11 females and the mean age of 22.5 years. Traumatic group consisted of 64 shoulders with 52 males, 7 females and the mean age of 24.3 years. Female in minor injury group was significantly more than that in traumatic group. There was no difference in general joint laxity and intraarticular findings between two groups. Range of external rotation in injured side in minor injury group was significantly more than that in traumatic group. Inferior laxity in both sides in minor injury group was more than that in traumatic group. In conclusion, the traumatic anterior shoulder instability due to minor injuries might incline to occur the shoulder in female and with inferior laxity of shoulder.

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Diagnostic Value of Computed Tomography in Acetabular Fracture (관골구 골절에서의 전산화단층촬영술의 진단적 가치)

  • Kim, Sun-Yong;Park, Bok-Hwan;Ihn, Joo-Chul
    • Journal of Yeungnam Medical Science
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    • v.5 no.1
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    • pp.43-48
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    • 1988
  • We retrospectively analysed 22 patients pelvic CT, in whom the acetabular fracture were suspected in plain film. And compared and analysed the computed tomogram findings and plain radiographic findings. The results were as follows. CT enables better evaluation of shape, extent, and degree of separation of fragment. CT was helpful in detecting the combinded fracture and soft tissue injuries. CT showed intraarticular loose bodies, which were invisible on plain film. In patients with pelvic trauma, no necessary changing position during CT examination. CT was useful demonstrates the remnant of intraarticular osseous fragment and adequacy of reduction after surgery.

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Physical therapy of soft tissue surround the knee joint (슬관절 연부조직의 물리치료에 관한 문헌적 고찰)

  • Lee, Joon-Hee;Yoon, Sang-Jib;Jeong, Young-Jun;Choi, Won-Ho
    • Journal of Korean Physical Therapy Science
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    • v.9 no.3
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    • pp.161-170
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    • 2002
  • knee injuries are among the most common problems confronting patients, physical therapist and physicians. since the bony structure provides little stability, the soft tissues are required to withstand high forces, often resulting in tissue overload and injury immobilization of the knee in the presence of a hemarthrosis usually leads to proliferation of intraarticular connective tissue adhesions and pint fibrosis. the physical basis of treating scar tissue is early controlled motion. the management of the knee with increased instability is to strengthening the muscles to properly treat an soft tissue injuries, physical therapist should know about the anatomic structures and biomechanical function of the knee joint, in this review article, we discuss the physiologic properties of soft tissue, biomechanical observation in fibrous connective tissue, managing soft tissue contractures, principles in treating scar tissue and treatment of the knee with increased instability.

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Arthroscopic Assessment of Potential Intra-articular Ankle Injury in Treatment of Ankle Fracture (족관절 골절의 치료에 있어 잠재적 관절 내 손상의 관절경적 평가)

  • Kim, Jung-Han;Gwak, Heui-Chul;Lee, Hyeong-Joo
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.4
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    • pp.151-155
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    • 2015
  • Purpose: The purpose of this study was to analyze the frequency and patterns of intra-articular lesions detected during ankle fracture surgery using ankle arthroscopy. Materials and Methods: Thirty patients (31 ankles) who underwent open reduction and internal fixation combined with ankle arthroscopy for acute ankle fracture at Inje University Busan Paik Hospital from June 2011 to September 2013 were evaluated. The ankle fractures were classified according to the AO/OTA (AO Foundation and Orthopaedic Trauma Association) classification and the intraarticular injuries were identified by ankle arthroscopy. Osteochondral lesions of the talus were divided into nine subtypes based on their locations, and the ligament injuries were classified according to avulsion fracture and rupture. Results: Using arthroscopy, abnormality in the distal tibiofibular ligament was found in 21 cases and osteochondral lesions and defects of the talus larger than 5 mm were detected in 26 cases. Among ligament injuries, anterior inferior tibio-fibular ligament injury was found in 14 cases, posterior inferior tibio-fibular ligament injury was found in two cases, deep deltoid ligament injury was found in three cases, and deep transverse tibio-fibular ligament injury was found in five cases. The locations of the osteochondral lesions were on the antero-lateral, antero-medial, centro-medial, centro-central, centro-lateral, and postero-lateral talus in 11, one, two, one, two, and nine cases, respectively. Conclusion: With early diagnosis and treatment arthroscopy performed at the time of intra-articular fracture surgery is expected to result in a good outcome.

Ulnar Nerve Injury Caused by the Incomplete Insertion of a Screw Head after Internal Fixation with Dual Locking Plates in AO/OTA Type C2 Distal Humerus Fractures

  • Shin, Jae-Hyuk;Kwon, Whan-Jin;Hyun, Yoon-Suk
    • Clinics in Shoulder and Elbow
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    • v.20 no.4
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    • pp.236-239
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    • 2017
  • After dual plating with a locking compression plate for comminuted intraarticular fractures of the distal humerus, the incidence of ulnar nerve injury after surgery has been reported to be up to 38%. This can be reduced by an anterior transposition of the ulnar nerve but some surgeons believe that extensive handling of the nerve with transposition can increase the risk of an ulnar nerve dysfunction. This paper reports ulnar nerve injuries caused by the incomplete insertion of a screw head in dual plating without an anterior ulnar nerve transposition for AO/OTA type C2 distal humerus fractures. When an anatomical locking plate is applied to a distal humeral fracture, locking screws around the ulnar nerve should be inserted fully without protrusion of the screw because an incompletely inserted screw can cause irritation or injury to the ulnar nerve because the screw head in the locking system usually has a slightly sharp edge because screw head has threads. If the change in insertion angle and resulting protruded head of the screw are unavoidable for firm fixation of fracture, the anterior transposition of the ulnar nerve is recommended over a soft tissue shield.