• 제목/요약/키워드: Knee surgery

검색결과 846건 처리시간 0.039초

전방 십자 인대 재건술: 골-슬개건-골 자가이식물 (ACL Reconstruction: Bone-Patellar Tendon-Bone Autograft)

  • 고해석
    • 대한관절경학회지
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    • 제9권2호
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    • pp.102-108
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    • 2005
  • 전방십자인대 손상은 모든 연령 대에서 고위험 운동에 참여하는 인구의 증가로 계속 증가하고 있다. 골-슬개건-골을 이용한 전방십자인대 재건술이 가장 많이 시행되는 수술이다. 지금까지 골-슬개건-골 자가이식물이 가장 이상적인 전방십자인대 재건술의 이식물이라고 하는 주장을 바꿀 만 한 충분한 자료가 아직 없다. 골-슬개건-골 이식물의 생체역학적 특징, 공여부 이환과 적응증을 고찰하고, 이를 이용한 내시경적 전방십자인대 재건술의 수술 수기를 기술하고자 한다.

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편마비 환자 경직의 반사적 및 역학적 성분의 분리를 통한 경직의 정량적 평가 (Quantitative Evaluation of Spasticity through Separation of Reflex and Mechanical Component Related to Spasticity in Hemiplegic Patients)

  • 김철승;엄광문;김지원;류제청;강성재;김요한;박병규
    • 한국정밀공학회지
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    • 제26권7호
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    • pp.142-149
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    • 2009
  • The aim of this study was to identify both the mechanical and reflex properties associated with spasticity in hemiplegic patients. Ten hemiplegic patients were included in this study. Multiple pendulum tests were executed for each subject, and knee joint angle and EMG of Rectus Femoris muscle were measured. The neuromusculoskeletal system model was developed from generally accepted mechanism and identified through minimization of the error in the model-predicted pendulum trajectories. The identification was successful in terms of small error in simulated kinematics and high sensitivity and precision of simulated torque against EMG activity. The reflex threshold showed significant difference between different clinical scores (p<0.01) and significant negative correlation (r=-0.93) with the EMG duration. It is expected that the suggested method may help in understanding mechanisms underlying spasticity.

Acute Subdural Hematoma after Accidental Dural Puncture During Epidural Anesthesia

  • Kim, Il-Sup;Lee, Sang-Won;Son, Byung-Chul;Hong, Jae-Taek
    • Journal of Korean Neurosurgical Society
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    • 제40권5호
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    • pp.384-386
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    • 2006
  • Acute subdural hematoma is an exceptionally rare, but life-threatening complication of spinal anesthesia. The authors report here on a case of acute subdural hematoma in a 52-year-old male who underwent an arthroscopic knee joint operation under spinal epidural anesthesia due to tearing of the medial meniscus. He complained of headache after surgery. Computed tomography[CT] revealed acute subdural hematoma in the right fronto-tempo-parietal area. The headache progressed in spite of analgesics and bed rest; two weeks later, the CT showed subacute subdural hematoma with a mass effect. The patient improved after surgical decompression. The pathogenesis of subdural hematoma formation after dural puncture is discussed and we briefly review the relevant literature. Prolonged and severe postdural puncture headache[PDPH] should be viewed with suspicion and investigated promptly to rule out any intracranial complications. Immediate treatment of the PDPH with an epidural blood patch to prevent further CSF leakage should be considered.

외측 반월상 연골에서 발생한 외상성 완전 방사상 파열 자가 치유의 자연 경과: 증례 보고 (Natural History of Spontaneous Healing of a Traumatic Radial Tear of the Lateral Meniscus: A Case Report)

  • 심재앙;윤용철;이신우;이범구
    • Journal of Trauma and Injury
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    • 제28권1호
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    • pp.21-26
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    • 2015
  • Complete radial tears of the lateral meniscus are relatively rare. Once torn, the injury can be debilitating due to disruption of the circumferential fibers of the meniscus. We experienced a case of a lateral meniscus with a complete radial tear at the midbody, where the two torn ends were displaced more than 1 cm and could not be approximated during arthroscopy. Thirteen months after surgery, follow-up MRI and second-look arthroscopic findings showed that the complete radial tear has healed spontaneously. However, twenty nine months after the second-look arthroscopy, the patient complained of severe knee pain during exercise. On follow-up MRI, increased sclerosis and newly developed bone marrow edema were observed in the lateral femoral condyle, compared with previous MR images. Finally, we performed meniscal allograft transplantation due to the defective properties of the completely healed lateral meniscus.

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반건양건내에 발생한 근육 경색 및 석회화: 증례 보고 (Muscle Infarction and Calcification of the Semitendinosus Tendon: A Case Report)

  • 조진호
    • 대한골관절종양학회지
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    • 제18권2호
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    • pp.89-93
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    • 2012
  • 석회화 건염은 주로 견관절이 가장 많이 호발하고 고관절, 슬관절 등 다른 부위의 관절에 발생하는 것으로 알려져 있다. 근육내에 허혈로 인한 근육 경색 또한 주로 당뇨병 환자에서 빈번한 합병증인 폐쇄성 혈관 병변에 의한 하지 원위부에 주로 발생하는 것으로 알려져 있다. 본 저자는 고령의 환자에서 당뇨병 같은 기존 질환이 없고 관절 부위가 아닌 하퇴 후방부 순수 건 내에 생긴 근육경색과 석회화가 같이 동반된 종괴 병변을 경험하였기에 이를 보고하고자 한다.

근력강화운동이 노인의 균형수행력에 미치는 영향 (Effect of Balance Performance in the Elderly by the Strengthening Exercise)

  • 김은주;이한숙;김종열;배성수
    • The Journal of Korean Physical Therapy
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    • 제11권2호
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    • pp.149-161
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    • 1999
  • The purpose of study wan to compare the effect of balance performance in the elderly by the strengthening exercise. Thirty-one health elderly women aged 60 to 79 years participated in this study. Participants were divided into exercise(21) and control group(10). Exercise participants received strengthening exercise for 45 minutes in three times a week for 6 weeks while control subjects continued their normal activities, Exercise included resisted hip flexion, extension, abduction and adduction, knee flexion and extension, ankle dorsiflexion and plantrarflexion. All subjects were assessmented clinical test of sensory interaction and balance. one leg stance test, Berg balance test. Exercise and control subjects were teated before, midway through, and at the end of the trial. These collected data were analyzed by using oneway and repeated ANOVA, scheffe's test, 1-test and correlation. The results of this study were as fellows. 1. There were statistically significant difference in balance performance clinical teat of sensory interaction, and balance(p<.01), one leg stance test(p<.05), Berg balance test(p<.05) by the strengthening exercise. 2. There was correlation between static balance and dynamic balance(p<.01). 3. There was correlation between static balance and weight(p<.05), dynamic balance and height(p<.01), and weight(p<.01).

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Ewing's Sarcoma of the Calcaneus:A Case Report

  • 최준혁
    • Journal of Yeungnam Medical Science
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    • 제21권2호
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    • pp.256-261
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    • 2004
  • 유잉육종은 소아와 청소년기에 발생하는 악성 골종양으로 주로 긴 뼈의 골간에 발생한다. 손과 발에 발생하는 유잉육종은 매우 드물다. 저자들은 왼쪽 발꿈치뼈에 발생한 유잉육종 1예를 경험하였기에 문헌 고찰과 함께 보고한다. 15세 여자가 왼쪽 발꿈치의 동통과 부종을 을 주소로 내원하였다. 방사선 소견에서 왼쪽 발꿈치뼈에 골용해성 및 골경화성 병변이 관찰되었다 수술 전 시행한 생검에서 종양세포들은 균일한 둥근 모양의 종양세포로 구성되어있었다. CD99에 대한 면역조직화학염색에서 대부분의 종양세포의 세포질이 강한 양성반응을 보였다. 유잉육종으로 진단을 하고 화학요법을 한 후 무릎밑절단을 시행하였다.

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전방 십자 인대 재건술에서 이식건 선택 (Graft Selection in ACL Reconstruction)

  • 이동철
    • 대한정형외과스포츠의학회지
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    • 제2권2호
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    • pp.92-99
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    • 2003
  • 스포츠 활동과 사고로 인하여 전방십자인대 재건술이 많이 증가하고 있으며 여러 종류의 자가 및 동종이식건이 많이 사용되어지고 있다. 자가 골-슬개건-골을 이용한 전방십자인대 재건술이 제일 대표적인 이식건으로 사용되고 있으나 공여부의 합병증과 전방슬관절통 등의 문제가 발생될 수 있으며 환자에 따라서 이러한 문제를 줄일 수 있는 다른 이식건의 사용도 필요할 수 있다. 여러 이식건의 생역학적인 특성, 장점 및 단점, 합병증을 충분히 이해함으로써 환자 개인에 맞는 적절한 이식건을 선택할 수 있으며 수술후 환자의 만족도를 높일 수 있을 것으로 생각된다

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좌측성상교감신경절차단후(左側星狀交感神經節遮斷後)에 합병증(合倂症)으로 온 좌측하지온감(左側下肢溫感) (Warm Sensation of Left lower Extremity as a Complication of Left Stellate Ganglion Block)

  • 오흥근
    • The Korean Journal of Pain
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    • 제1권1호
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    • pp.125-128
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    • 1988
  • A case of the left stellate ganglion block (SGB) with a warm serration of the left lower extremity in a 25-year-old male soldier is presented. During the Korean War, this patient received a penetrating gun shot wound from the right knee through the left abdominal wall, left upper arm and left thumb. He was evacuated to the a marine corps surgical hospital where amputation of the left thumb and an end-to-end anatomosis of the left brachial artery were performed. After surgery, left ulnar and median nerve paralysis and causalgia developed and about 9 months later an upper thoracic ganglionectomy was proposed at the Chin-Hae Navel Hospital. Before the ganglionectomy a stellate ganglion block for diagnostic and prognostic purposes was requested by the surgeon. This block was performed by the supraclavicular anterior approach using 10 ml of 2% procaine. The effect of the block including Horner's syndrome was confirmed 5 minute later in this patient. This patient returned to the ward by walking unassisted 10 minutes after the block, and complained of a warm sensation in the left lower extremity 20 minutes later as well as the left upper arm. This warm sensation in the lower extremity following ipsilateral stellate ganglion block indicates that the local anesthetics solution injected tinto the neck spread down to lumbar sympathetic ganalgion along the fascial membrane of the sympathetic chain as a consequence of the 10 minutes walk.

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Useful effect of a clinical shoe insole, Mubal®, as orthotics

  • Park, Chan-Lee;Go, Ji-Hyun;Han, Na-Ra;Moon, Hong-Hee;Seo, Min-Jun
    • 셀메드
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    • 제5권2호
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    • pp.10.1-10.3
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    • 2015
  • Arthritis is a major cause of joint pain, stiffness, and subsequent disability which adversely affects quality of life. Seriously, it can lead to long term social and psychological effects including loss of independence, depression, and anxiety. Arthritis is usually treated with joint replacement surgery or medications. However, the artificial joint is temporary and pharmacological measures have side effects, such as addiction or hypersensitivity. Thus, orthotics has been developed to improve arthritis as a nonpharmacological measure. The increased regional load across compartments of articular cartilage is an important factor in the cause of the arthritis. Mubal$^{(R)}$, a clinical shoe insole, has a sliding function to help people to walk straight and realign the body balance. The slide of Mubal$^{(R)}$ reduces the knee joint loading in patients with arthritis. In addition, pumping function of Mubal$^{(R)}$ can mitigate arthritis by stretching the squashed nerves from lumbar to cervical vertebral and actively circulating blood of pelvic limb. In addition, Mubal$^{(R)}$ could help to stimulate the growth plate. Therefore, Mubal$^{(R)}$ can be used for the child with short stature as well as patients with arthritis.