• Title/Summary/Keyword: Joint instability

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Vertical Reduction Using Atlantoaxial Facet Spacer in Basilar Invagination with Atlantoaxial Instability

  • Kim, Il-Sup;Hong, Jae-Taek;Sung, Jae-Hoon;Byun, Jae-Hoon
    • Journal of Korean Neurosurgical Society
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    • v.50 no.6
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    • pp.528-531
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    • 2011
  • Although posterior segmental fixation technique is becoming increasingly popular, surgical treatment of craniovertebral junctional disorders is still challenging because of its complex anatomy and surrounding critical neurovascular structures. Basilar invagination is major pathology of craniovertebral junction that has been a subject of clinical interest because of its various clinical presentations and difficulty of treatment. Most authors recommend a posterior occipitocervical fixation following transoral decompression or posterior decompression and occipitocervical fixation. However, both surgical modalities inadvertently sacrifice C0-1 and C1-2 joint motion. We report two cases of basilar invagination reduced by the vertical distraction between C1-2 facet joint. We reduced the C1-2 joint in an anatomical position and fused the joint with iliac bone graft and C1-2 segmental fixation using the polyaxial screws and rods C-1 lateral mass and the C-2 pedicle.

Biologic Arthroplasty of Elbow with Free Metatarso-Phalangeal Joint Transplantation (유리 중족-족지관절 이식술을 이용한 주관절 전치환술)

  • Chung, Duke Whan
    • Archives of Reconstructive Microsurgery
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    • v.9 no.2
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    • pp.154-157
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    • 2000
  • Author report a case of double metatarso-phalangeal joint transplantation to the elbow joint in the 31 years old female patient who have large bone defect associated with skin and soft tissue defect. The donor joints were second and third metatarso-phalangeal joint as double joint transfer fashion to enhance stability of graft. The graft based on dorsalis pedis vessel to anastomosed with radial artery of recipient site. The result is unsatisfactory because of long lasting lateral instability of reconstructed elbow joint in spite of 40 degree flexion motion and fair axial stability. We can conclude that joints from foot can not be an effective donor for biologic joint arthroplasty of elbow joint even though double metatarso-phalangeal joint were harvested.

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An Isolated Complete Rupture of Radial Collateral Ligament of the Fifth Metacarpophalangeal Joint: A Case Report (제 5중수 수지관절에 단독으로 발생한 요측 측부 인대 완전 파열의 치험례)

  • Kim, Cheol Hann;Tark, Min Sung
    • Archives of Plastic Surgery
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    • v.33 no.6
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    • pp.780-783
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    • 2006
  • Purpose: Rupture of a collateral ligament of the metacarpophalangeal joint is rare except in the thumb. The injured digit became flexed and deviated toward ulna side by the hypothenar intrinsic musculature. Incomplete rupture of a collateral ligament of the metacarpophalangeal joint can be often managed by splinting the affected digit in flexion position, however, in the case of complete tears that distraction of the ends of the ruptured collateral ligament is too great to allow repositioning by splinting. Primary repair of the ruptured collateral ligament or reattachment to bone by a pull-out wire, or tendon graft technique appears to be adequate. Methods: We report a case of instability of fifth metacarpophalangeal joint due to complete rupture of radial collateral ligament. This 18-year-old male presented pain in his right outstretched hand after trauma. The diagnosis was obtained by physical examination and simple radiography. Because of persistent instability after the initial conservative treatment, open reduction and repair surgical treatment was required. Results: The fifth metacarpophalangeal joint became free of pain and stable under forced lateral deviation. Postoperative results showed good metacarpophalangeal joint function and stability during 8 months follow-up period. Conclusion: Because of the interposition of the sagittal band between the ruptured ends of radial collateral ligament such as Stener-like lesion of the thumb, surgical repair of metacarpophalangeal joint collateral ligament of the finger was justified in case of complete laxity in full flexion.

Inferior Capsular Shift for Multidirectional Shoulder Instability in Contact Sports Athletes (접촉성 운동 선수에서 견관절 다방향 불안정성에 대한 하방 관절막 이동술)

  • Choi Chong-Hyuk;Yun Kyung-Hwan;DJ Ogilvie-Hanis
    • Clinics in Shoulder and Elbow
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    • v.3 no.1
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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.

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