• 대한족부족관절학회지
• /
• 제24권1호
• /
• pp.1-8
• /
• 2020

Acute ankle sprain is the most common injury in the lower extremities, and approximately 10% to 40% of acute lateral ankle ligament injury causes chronic pain or instability. For chronic symptoms lasting after an acute sprain, the possibility of joint damage, such as bony structures, ligaments, cartilage, and nerves around the ankle joint, should be considered. Patients with chronic lateral ankle instability usually complain of repeated sprains or giving way sensations. There has been steady progress in the treatment options until recently, however new treatments are still being attempted. This paper describes the causes, diagnosis, and recent trends in the conservative and operative treatment of chronic lateral ankle instability.

• 대한방사선협회지
• /
• 제27권2호
• /
• pp.115-123
• /
• 2001

The two ligaments, the anterior talofibular ligament(ATFL) and the calcaneofibular ligament(CFL), arise from the anteroinferior aspect of the lateral malleolus, and therefore avulsion fragments are superimposed on the lateral malleolus on the srandard rad

• 대한족부족관절학회지
• /
• 제23권1호
• /
• pp.6-11
• /
• 2019

As a result of the increased participation in recreational and competitive sports activity, the incidence of chronic lateral instability has risen. Because chronic ankle instability can cause significant comorbidity and increase the social cost, the interest in this issue is growing. Although there are well-documented and effective surgical treatments for managing this condition, conservative treatments are a viable first option in selected patients. Through conservative treatment, surgical treatments can be reduced or delayed without necessarily affecting the overall outcome, but the failure of conservative treatment results in the need for surgical treatment to reduce the long term complications. Appropriate postoperative rehabilitation is essential for adequate functional recovery, even when surgical treatment is required.

• 대한족부족관절학회지
• /
• 제2권1호
• /
• pp.6-12
• /
• 1998

Many surgical procedures have been described for the treatment of chronic lateral instability of the ankle. Tenodesis procedures using peroneus brevis tendon is traditionally common among them. Recently, the modified Brostrom anatomic procedure, that is, tightening the stretched out lateral ligaments to restore their norma] anatomy without the use of supplemental tissues and then suturing the lateral portion of the extensor retinaculum to the distal fibula over the ligament repair. has been gaining in popularity. We have reviewed 6 of 10 consecutive cases at an average of 17 months after modified Brostrom procedure. An excellent or good result was achieved in 5 cases, all of which had improved mechanical stability as measured radiographically. One case that had an unsatisfactory result was in patient who had had a previous Evans' operation. So, we believed that the modified Brostrom procedure is an excellent treating method for chronic lateral instability of the ankle.

• Archives of Plastic Surgery
• /
• 제48권2호
• /
• pp.158-164
• /
• 2021

Background In lower lateral cartilage (LLC) surgery, cephalic trimming poses risks for the collapse of the internal and external nasal valves, pinched nose, and drooping deformity. The cephalic lateral crural advancement (CLCA) technique presented herein was aimed at using a flap to increase nasal tip rotation and support the lateral crus, in addition to the internal and external nasal valves, by avoiding grafts without performing excision. Methods This study included 32 patients (18 female and 14 male) and the follow-up period for patients having undergone primer open rhinoplasty was 12 months. The LLC was elevated from the vestibular skin using the CLCA flap. A cephalic incision was performed without cephalic trimming. Two independent flaps were formed while preserving the scroll ligament complex. The CLCA flap was advanced onto the lower lateral crus while leaving the scroll area intact. The obtained data were analyzed retrospectively. Results The mean age of the patients was 31.6 years (range, 20-51 years). The Rhinoplasty Outcome Examination scores after 12 months varied from 90 to100 points, and 93% of patients reported perfect satisfaction. At a 1-year follow-up, the patients' nasal patency (visual analogue scale) rose from 4.56±1.53 (out of 10) to 9.0±0.65 (P<0.001). Conclusions The CLCA flap led to better nasal tip definition by protecting the scroll area, increasing tip rotation, and supporting the internal and external nasal valves without cephalic excision.

• 대한족부족관절학회지
• /
• 제22권2호
• /
• pp.55-61
• /
• 2018

Chronic lateral ankle instability is a major complication of acute ankle sprains, which can cause discomfort in both daily and sports activity. In addition, it may result in degenerative changes to the ankle joint in the long term. An accurate diagnostic approach and successful treatment plan can be established based on a comprehensive understanding of the concept of functional and mechanical instability. The patients' history and correct physical examination would be the first and most important step. The hindfoot alignment, competence of the lateral ligaments, and proprioceptive function should be evaluated. Additional information can be gathered using standard and stress radiographs. In addition, concomitant pathologic conditions can be investigated by magnetic resonance imaging. Conservative rehabilitation composed of the range of motion, muscle strengthening, and proprioceptive exercise is the main treatment for functional instability and mechanical instability. Regarding the mechanical instability, surgical treatment can be considered for irresponsible patients after a sufficient period of rehabilitation. Anatomic repair (modified $Brostr{\ddot{o}}m$ operation) is regarded as the gold standard procedure. In cases with poor prognostic factors, an anatomical reconstruction or additional procedures can be chosen. For combined intra-articular pathologies, arthroscopic procedures should be conducted, and arthroscopic lateral ligament repair has recently been introduced. Regarding the postoperative management, early functional rehabilitation with short term immobilization is recommended.

• 대한족부족관절학회지
• /
• 제23권1호
• /
• pp.1-5
• /
• 2019

Surgical treatment to restore stability in the ankle and hindfoot and prevent further degenerative changes may be necessary in cases in which conservative treatment has failed. Anatomical direct repair using native ligament remnants with or without reinforcement of the inferior retinaculum is the so-called gold standard operative strategy for the treatment of lateral ankle instability. Non-anatomical lateral ligament reconstruction typically involves the use of the adjacent peroneus brevis tendon and applies only those with poor-quality ligaments. On the other hand, anatomic reconstruction and anatomic repair provide better functional outcomes after the surgical treatment of chronic ankle instability patients compared to a non-anatomic reconstruction. Anatomical reconstruction using an autograft or allograft applies to patients with insufficient ligament remnants to fashion direct repair, failed previous lateral ankle repair, high body mass index, or generalized ligamentous laxity. These procedures can provide good-to-excellent short-term outcomes. Arthroscopic ligament repair is becoming increasingly popular because it is minimally invasive. Good-to-excellent clinical outcomes have been reported after short and long-term follow-up, despite the relatively large number of complications, including nerve damage, reported following the procedure. Therefore, further investigation will be needed before widespread adoption is advocated.

• 대한후두음성언어의학회지
• /
• 제20권2호
• /
• pp.126-130
• /
• 2009

Arytenoid motion has long been recognized as complex. Misunderstandings about the specifics of arytenoid motion remain prevalent. The resultant misunderstandings have led to erroneous or suboptimal clinical approaches to the treatment of vocal fold immobility. A thorough understanding of the anatomy of the arytenoid and cricoid cartilages, the cricoarytenoid joint, and related ligaments, muscles, and other structures is essential in order to fully understand laryngeal motion disorders. Arytenoid motion occurs in three directions. Movements involving a change anteriorly and posteriorly, as well as vertically, are due to the revolving or pitchlike motion of the arytenoid along the minor axis of the cricoid's elliptically shaped facet. The medial and lateral movements are due to the orientation of the arytenoid which in turn is determined by the forward, lateral, and inferior inclination of the cricoid-arytenoid facet. During adduction it is the outward angulation of the vocal process from the body of the arytenoid that allows the entire length of the vocal proceses to approximate one another and to have this meeting occur at the proper vertical height.

• 한국정밀공학회:학술대회논문집
• /
• 한국정밀공학회 2002년도 추계학술대회 논문집
• /
• pp.1059-1061
• /
• 2002

A FE model is to develop a personalized biomechanical model of the scoliotic spine that will allow the design of clinical test providing optimal estimation of the post-operation results. A flexible multi-body model of the spine including rib cage, clavicle, and scapular was developed to simulate several mobility simulations. Vertebrae, clavicle and scapular were represented using rigid bodies and ribs and sternum were modeled as flexible bodies. Kinematical Joints and spring elements were used to represent the intervertebral disc and ligaments respectively. Postero-anterior and lateral radiographics of a scoliotic spine were used to represent a 3D reconstruction. CT data for same patient were also used to verify vertebrae rotation driven from postero-anterior and lateral radiographic images. Simulated results showed good reducibility almost uniformly distributed along the spinal segments. It was also found that boundary and loading conditions, required to mimic the operation procedures, were proven to be very sensitive parameters to its results rather than its mechanical properties

• 한국정밀공학회:학술대회논문집
• /
• 한국정밀공학회 2005년도 춘계학술대회 논문집
• /
• pp.907-910
• /
• 2005

Although several artificial disc designs have been developed for the treatment of discogenic low back pain, biomechanical change with its implantation was rarely studied. To evaluate the effect of artificial disc implantation on the biomechanics of functional spinal unit, nonlinear three-dimensional finite element model of L4-L5 was developed with 1-mm CT scan data. Two models implanted with artificial discs, SB $Charit\acute{e}$ or Prodisc, via anterior approach were also developed. The implanted model predictions were compared with that of intact model. Angular motion of vertebral body, force on spinal ligaments and facet joint, and the stress distribution of vertebral endplate for flexion-extension, lateral bending, and axial rotation with a compressive preload of 400 N were compared. The implanted model showed increased flexion-extension range of motion and increased force in the vertically oriented ligaments, such as ligamentum flavum, supraspinous ligament and interspinous ligament. The increase of facet contact force on extension were greater in implanted models. The incresed stress distribution on vertebral endplate for implanted cases indicated that additinal bone growth around vertebral body and this is matched well with clinical observation. With axial rotation moment, relatively less axial rotation were observed in SB $Charit\acute{e}$ model than in ProDisc model.