• Clinics in Shoulder and Elbow
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• 제11권2호
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• pp.172-176
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• 2008

목적: 견봉쇄골관절의 탈구에 대한 수술적 방법으로 많은 방법들이 소개되었지만, 적합한 방법에 대해서는 논란이 있다. 이전의 문제점들을 보완한 새로운 방법들이 많이 개발되고 있지만, 충분한 고정력을 가지고 조기 관절 운동을 가능하게 하는 것이 공통적인 관심사일 것이다. 저자들은 급성 견봉 쇄골 관절 탈구로 진단된 10예의 환자에서 관절경과 TightRope$^{(R)}$(Arthrex, Inc, Naples, FL, 34108, USA)를 이용하여 고정술을 시행하였다. 대상 및 방법: 2007년 4월부터 2007년 12월까지 TightRope$^{(R)}$를 이용하여 수술을 시행하고 10개월이상 추시가 가능하였던 급성 견봉쇄골관절탈구 환자 10예를 대상으로 하였다. 수술전후의 방사선적 평가는 견봉쇄골관절의 견갑 부하 촬영 사진을 이용하여 건측과 비교하였으며, 임상적인 평가는 Imatani의 평가법에 따라 통증, 기능, 관절의 운동범위에 대해 평가하였고, 술후 10개월에 평가를 시행하였다. 결과: Imatani의 평가법을 이용한 임상적 평가에서 우수가 6예, 양호가 3예, 불량이 1예였고, 방사선적 평가는 우수가 9예, 불량이 1예로 나타났으며, 1예에서 재탈구가 발생하였다. 결론: 비교적 단기간의 추시에서 TightRope$^{(R)}$를 이용하여 수술한 10명의 환자 중 재탈구가 일어난 1명을 제외한 9명의 환자에서 Imatini 및 방사선 평가에서 우수한 결과를 보였다.

• Clinics in Shoulder and Elbow
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• 제13권1호
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• pp.34-39
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• 2010

목적: 견봉쇄골 관절의 급성 탈구에서 원추인대 기능의 강화를 위한 봉합 나사못을 추가한 변형된 Phemister 술식의 치료 방법을 소개하고 그 결과를 알아보고자 하였다. 대상 및 방법: 14예의 환자를 대상으로 하였으며 Rockwood 제 3형이 11예, 5형이 3예 였고 환자의 평균나이는 45.2세 였다. 변형된 Phemister 술식에 원추인대 기능의 강화를 위한 봉합 나사못을 추가하여 수술하였다. 추시 기간은 평균 14개월이었으며 술 후 임상적 평가는 Weitzman 분류 및 VAS 점수와 Constant 점수, KSS 점수를 사용하였다. 결과: Weitzman 분류상 13예에서 우수, 1예에서 양호로 평가되었고 평균 관절 운동 범위는 전방거상 170.7도, 외전 166.4도, 외회전 68.2도, 내회전 T7 였다. 평균 VAS 점수는 1.9, 평균 Constant 점수는 90.8점, 평균 KSS 점수는 91점이었다. 방사선학적 평가 결과는 모든 예에서 양호한 결과를 얻었다. 결론: 견봉쇄골 관절의 급성 탈구에서 원추인대 기능의 강화를 위한 봉합 나사못을 추가한 변형된 Phemister 술식은 임상적으로 유용한 수술 방법으로 사료된다.

• Clinics in Shoulder and Elbow
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• 제3권1호
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• pp.10-19
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• 2000

The aims of this retrospective study were to evaluate the results of inferior capsular shift operation which were approached anteriorly or posteriorly according to a main instability direction in contact sports population who had multidirectional shoulder instability. Fifty-three shoulders in 47 athletes who engaged in contact sports underwent an anterior or posterior inferior capsular shift procedure for the correction of multidirectional instability of the shoulder joint. The surgical approach was selected according to the predominant direction of the instability. Follow up was average of 42 months(24∼73 months). After anterior inferior capsular shift, anterior dislocation was recurred in three shoulders, posterior dislocation in one, and inferior dislocation in two shoulders. After posterior inferior capsular shift, one dislocation occurred anteriorly, one inferiorly and one posteriorly. The excessive tightening of capsule or improper diagnosis could be causative factors for the development of dislocation in the opposite direction to the preoperative major instability. Of six patients who could not return to their sports, five had bilateral repairs. Successful repair based on the criteria of the American shoulder and elbow association was achieved in 92% of anterior repairs, and 81 % of posterior repairs.

• Clinics in Shoulder and Elbow
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• 제8권2호
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• pp.181-186
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• 2005

An anterior dislocation of the elbow without a fracture of the olecranon is an extremely rare injury. This paper reports a 36-year-old male who stumbled and fell on his outstretched hand during a soccer game. The anteroposterior and lateral radiographs indicated a simple anterior dislocation of the elbow, which was reduced using a closed method. The elbow joint was stable in the range of motion, but the sensation of the two ulnar digits was still reduced. MRI was useful for the identification of the pathoanatomy. At the follow-up examination three months after the initial trauma, the hypesthesia has fully recovered and the patient regained the full range of the elbow and forearm motion without pain and instability. After 18 months, the patient had a normal elbow function, and could play various sports. If an anterior elbow dislocation is detected early, a closed reduction with careful pathoanatomical considerations would be successful.

• 대한치과의사협회지
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• 제9권5호
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• pp.217-221
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• 1971

Authors studied on the T.M.J. dislocation of 5 cases who were visit Dental College Infirmary, S.N.U. The results were obtained as follows. 1) The main symptoms are pain, cracking sound, discomfort of temporomandibular joint region and swelling. 2) All cases except only one case, no specific etiological factors were detected in related to habitual custom and hoby. 3) The patients are all female aged from 19 to 24 years old.

• 대한치과마취과학회지
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• 제14권3호
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• pp.173-175
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• 2014

Atypical facial pain is loosely used term to describe some chronic facial pain when the symptoms do not exactly and entirely fit one diagnostic criteria. In many cases of pain disorders, sympathetic system is involved, such as in conditions which symptoms mimic post-herpetic neuralgia or complex regional pain syndrome. We report a case of a patient with atypical facial pain following the reduction of temporomanidbular joint dislocation. The atypical pain which was resistant to analgesic medication was successfully managed with stellate ganglion block. Therefore we suggest that stellate ganglion block can be an effective treatment method for controlling atypical facial pain.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2002년도 학술대회
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• pp.90-90
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• 2002

• Clinics in Shoulder and Elbow
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• 제17권4호
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• pp.159-165
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• 2014

Background: Kirschner's wire (K-wire) transfixation and locking hook plate fixation techniques are widely used in the treatment of acute acromioclavicular joint (ACJ) dislocation. The purpose of this study was to compare the clinical and radiologic outcomes between K-wires transfixation and a locking hook plate fixation technique. Methods: Seventy-seven patients with acute ACJ dislocation managed with K-wire (56 shoulders) and locking hook plate (21 shoulders) were enrolled for this study. The mean follow-up period was 61 months. Results: At the last follow-up, the shoulder rating scale of the University of California at Los Angeles (UCLA) was higher in patients treated with locking hook plate than with K-wires ($33.2{\pm}2.7$ vs. $31.3{\pm}3.4$, p=0.009). In radiologic assessments, coracoclavicular distance (CCD) (7.9 mm vs. 7.7 mm, p=0.269) and acromioclavicular distance (ACD) (3.0 mm vs. 1.9 mm, p=0.082) were not statistically different from contralateral unaffected shoulder in locking hook plate fixation group, but acromioclavicular interval (ACI) was significant difference. However, there were significant differences in ACI, CCD, and ACD in K-wire fixation group (p<0.001). Eleven complications (20%) occurred in K-wire transfixation group and 2 subacromial erosions on computed tomography scan occurred in locking hook plate fixation group. Conclusions: ACJ stabilization was achieved in acute ACJ dislocations treated with K-wires or locking hook plates. Locking hook plate can provide higher UCLA shoulder score than K-wire and maintain CCD, and ACD without ligament reconstruction. K-wire transfixation technique resulted in a higher complication rate than locking hook plate.

• 대한족부족관절학회지
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• 제1권2호
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• pp.112-118
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• 1997

Tarsometatarsal fracture-dislocation is uncommon but severe lesion. Since this lesion is sometimes difficult to recognize by roentgenography, it is easily overlooked. Three patients were treated with open reduction and internal fixation with 3.5 mm cannulated screw and K-wire, two had treatment with open reduction and internal fixation with 3.5 mm cannulated screw only and two had treatment with dosed reduction and short leg cast only between January 1994 and May 1996. The duration of follow-up ranged from twelve to twenty-nine months after the diagnosis. Results were assessed by a subjective questiormaire, physical examination, and radiographic analysis. Multiple fixation techniques for maintaining the reduction of tarsometatarsl joint have been introduced. We recent]y used the 3.5 mm cannulated screw for internal fixation of the tarso-first and second metatarsal fracture-dislocation. We think cannulated screw fixation has several advantages; 1. The cannulated screw fixation is more rigid than the K-wire fixation. 2. There is an decreased risk of screw breakage with early weight bearing. 3. It is possible to compress the involved joints, if necessary. There were no disability in all patients. One patient who was treated with delayed open reduction and internal fixation with 3.5 mm cannulated screw and K-wire had a radiographic mild degenerative arthritis. And one patient who was treated with dosed reduction and short leg cast had a mild metatarsus adductus. But. these two patients were symptom free. There was no correlation between the severity of the diastasis and the patient s functional result.

• Clinics in Shoulder and Elbow
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• 제1권2호
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• pp.180-185
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• 1998

There has been considerable controversy as to the treatment method of dislocation of the acromioclavicular joint, so various operative treatment modalities have been suggested. We analyzed the results of 40 patients with acromio­clavicular dislocation, in whom twenty patients were treated by modified Phemister method and 20 patients by modified Weaver-Dunn method above follow-up two years. The purpose of this study was to compare the clinical results of two operative methods. According to Weitzman criteriae for clinical results, 12 cases were excellent, six cases good and two cases fair in modified Phemister method. But in modified Weaver-Dunn method, ten cases were excellent, eight cases good, one case fair and one case poor. In radiological result, coracoclavicular distance was measured at preoperative, postoperative and last follow-up period. The modified Phemister method was 6.lmm, 1.5mm and 2.4mm respectively, and the modified Weaver-Dunn method 7.8mm, 2.lmm and 2.5mm respectively. The complications were two cases of heterotopic ossification, one case of inadequate fixation and one case of K-wire breakage in modified Phemister method, and two cases of early fixation loss and one case of heterotopic ossification in modified Weaver-Dunn method. We obtained that the clinical, functional and radiological results showed no significant difference in two methods. The modified Phemister method was effective treatment for old patients in acute injuries due to short operation time and simple technique. The modified Weaver-Dunn method, as a reconstructive operation that reduces various complications for young and active male patients, was also good for getting the stability of coraco­clavicular ligament through clavicular bony union.