• Title/Summary/Keyword: Lateral ligaments

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Therapeutic Effect of a Double Locking-loop Suture Pattern on the Elbow Luxation with Rupture of Collateral Ligament in a Dog (곁인대가 파열되고 주관절이 탈구된 개에서 이중 Locking-loop 봉합법의 치료효과)

  • Lee Jae-yeong;Kim Joong-hyun;Kim So-seob;Lee Seung-keun;Choi Seok-hwa
    • Journal of Veterinary Clinics
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    • v.21 no.4
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    • pp.406-408
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    • 2004
  • A nine-month-old male Jindo with non weight-bearing on the right forelimb in flexed position, pain and edema of the elbow, and resist elbow extension was brought to the Veterinary Teaching Hospital, Chungbuk National University. Elbow radiographs showed loss of humeroradial joint space and lateral displacement of the radius and ulna. Closed reduction was reported the best therapy in most cases of luxation of the elbow but conservative reduction was impossible. Open reduction of the luxated elbow was performed and ruptured collateral ligaments were identified. Displaced elbow was required bloody surgical operation and gentle reduction to restore elbow joint. Internal reduction of choice for elbow luxation with rupture of collateral ligament in the dog was a double locking-loop suture pattern. To ensure secure grasping of parallel bundles of ligament fibers to transverse bites of each suture were placed superficial to the longitudinal bites. All ligaments were repaired with 3-metric (size 2 USP) monofilament polypropylene suture. No complications have been noted during a five-month follow up.

Movement Patterns of Head and Neck in Proprioceptive Neuromuscular Facilitation (고유수용성 신경근 촉진법의 두부·경부 운동 패턴)

  • Bae, Sung-soo;Kim, Sang-soo
    • PNF and Movement
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    • v.3 no.1
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    • pp.27-34
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    • 2005
  • Objective : The purpose of this study was conducted to find correct head and neck patterns, manual contact. verbal commands with proprioceptive neuromuscular facilitation(PNF). Method : This is a literature study with books, seminar note and book for PNF international course. Result : Keep the information of the biomechanics and neural science in head and neck patterns and emphasize that manual contact, verbal commands and visual stimulus. Manual contacting for movement guide and stability of the $C_0/C_1$ verbal command and visual stimulus for correcting of the $C_0/C_1$ movements. Conclusion : In reminder for PNF learning, begin with head and neck and upper trunk patterns. In that time, Knott and Voss(1968) had not enough information about biomechanic movement components and neural science movement components. But Knott and Voss(1968) emphasized that head and neck patterns relate with trunk, upper extremities and lower extremities directly. Alar ligaments are relaxed with the head in neutral and taut in flexion. Axial rotation of the head and neck tightens both alar ligaments. The right upper and left lower portions of the alar ligament limit left lateral flexion of the head and neck. Therefore, head and neck patterns has to be modify. When head moving, eye and vestibular stimulus will be change. During head and neck patterns, must be consider about stimulus of eye system and vestibular system also.

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Selective Neurotomy of Sacral Lateral Branches for Pain of Sacroiliac Joint Dysfunction

  • Kim, Hyo-Joon;Shin, Dong-Gyu;Kim, Hyoung-Ihl;Shin, Dong-A
    • Journal of Korean Neurosurgical Society
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    • v.38 no.5
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    • pp.338-343
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    • 2005
  • Objective : The sacroiliac joint complex is often related with functionally incapacitating pain in old aged people. The purpose of this study is to delineate the investigation strategies and to determine the long-term effect of radiofrequency [RF] neurotomies for pain arising from sacroiliac Joint dysfunction[SIJD]. Methods : Sixteen patients were diagnosed as having chronic pain from SIJD by comparative controlled blocks on L5 dorsal rami, sacroiliac Joints and deep interosseous ligaments. After confirming the positive response [more than 50% of pain relief], sensory stimulation was applied to detect the 'pathological' branches. Subsequently, RF neurotomies were performed on the selected nerve branches. Surgical outcome was graded as successful, moderate improvement, and failure after a 6month follow-up period. Results : Stimulation intensity was 0.45V to elicit pain response in the L5 dorsal rami and lateral sacral branches. The number of RF-lesioned nerve branches was 6per patient. The average number of lesions for each branch was 1.3. Most commonly selected branches were L5 dorsal ramus [88%] and S2-upper division [88%]. Ten patients [63%] reported a successful outcome according to the outcome criteria after 6months of follow-up, and five patients [31%] reported complete relief [100%]. Five patients [31%] showed moderate improvements. One patient reported failure. Conclusion : RF neurotomy of lateral sacral branches is an excellent treatment modality for the pain due to SIJD, provided that comparative controlled block shows a positive response.

Pigmented Villonodular Synovitis of the Ankle and Subtalar Joint Treated by Surgical Excision and Ligament Reconstructions: A Case Report

  • Shin, Jae-Hyuk;Lee, Byung Hoon;Kim, Gab-Lae;Kim, Kwon
    • Journal of Korean Foot and Ankle Society
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    • v.20 no.4
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    • pp.192-195
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    • 2016
  • Diffuse pigmented villonodular synovitis (PVNS) involving ankle joint needs complete mass excision and total synovectomy to reduce recurrence rate, while surrounding ligaments can be easily damaged. So the concurrent ligament reconstruction should be considered for post-excisional instability in subtalar joint as well as lateral ankle joint. We describe our experience in the management of a diffuse type PVNS, invades lateral talocrural joint extended to subtalar joint and introduce a new technique of all-in-one reconstruction for anterior talofibular,calcaneofibular and cervical ligament. Our new reconstruction technique applying modified Chrisman and Snook technique is useful in stabilization for deficiencies of the ligament complexafter PVNS excisionat lateral ankle and subtalar joint.

Reconstruction for Chronic Lateral Instability of the Ankle by Chen Method (Chen 술식을 이용한 족근관절의 만성 외측 불안정에 대한 재건술)

  • Lee, Gi-Haeng;Yoo, Jong-Min;Na, Gee-Tae;Kong, Yoon-Bae;Chu, In-Tak
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.1
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    • pp.53-57
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    • 2010
  • Purpose: This study was designed to evaluate the clinical and radiographical results of anatomical reconstruction by Chen method for chronic lateral ankle instability. Materials and Methods: Fifteen patients with chronic lateral ankle instability who had undergone anatomical reconstruction of anterior talofibular and calcaneofibular ligaments by Chen method were evaluated retrospectively. Average age of the patients was 31.3 years, and average follow-up period was 15.5 months. Preoperative and postoperative radiographs including varus stress view and magnetic resonance imaging (MRI) were analyzed. The clinical evaluation was performed according to the American Orthopaedic Foot and Ankle Society (AOFAS) scale. Results: Radiographically average talar tilt angle was $15.3^{\circ}$ preoperatively, and the difference with contralateral normal side was $10.1^{\circ}$. At last follow up, talar tile angle and the difference with contralateral side improved to $5.9^{\circ}$ and $1.3^{\circ}$ respectively. AOFAS scale was 66.6 preoperatively and 87.3 postoperatively. In MRI findings, four patients had associated intra-articular lesion such as articular cartilage defect, synovitis and osteoarthritis. The talar tilt angle improvement and AOFAS scale of patients without intra-articular lesion was better than those of four patients with intra-articular lesions. Surgical wound pain occurred in six patients and sural neuropathy in three patients. Conclusion: The anatomical reconstruction by Chen method was an easy and effective procedure for symptomatic chronic lateral ankle instability. Careful operative technique may prevent the surgical wound pain and sural neuropathy.

Incidence of pterygospinous and pterygoalar bridges in dried skulls of Koreans

  • Ryu, Sol-Ji;Park, Min-Kyu;Lee, U-Young;Kwak, Hyun-Ho
    • Anatomy and Cell Biology
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    • v.49 no.2
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    • pp.143-150
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    • 2016
  • Understanding of morphological structures such as the sphenoid spine and pterygoid processes is important during lateral transzygomatic infratemporal fossa approach. In addition, osseous variations such as pterygospinous and pterygoalar bridges are significant in clinical practice because they can produce various neurological disturbances or block the passage of a needle into the trigeminal ganglion through the foramen ovale. Two hundred and eighty-four sides of Korean adult dry skulls were observed to carry out morphometric analysis of the lateral plate of the pterygoid process, to investigate, for the first time among Koreans, the incidence of the pterygospinous and pterygoalar bony bridges, to compare the results with those available for other regional populations, and to discuss their clinical relevance as described on literatures. The mean of maximum widths of the left and right lateral plates of the pterygoid process were 15.99 mm and 16.27 mm, respectively. Also, the mean of maximum heights of the left and right lateral plates were 31.02 mm and 31.01 mm, respectively. The ossified pterygospinous ligament was observed in 51 sides of the skulls (28.0%). Ossification of the pterygospinous ligament was complete in four sides (1.4%). In 47 sides (16.6%), the pterygospinous bridge was incomplete. The ossified pterygoalar ligament was observed in 24 sides of the skulls (8.4%). Ossification was complete in eight sides (2.8%) and incomplete in 16 sides (5.6%). This detailed analysis of the lateral plate of the pterygoid process and related ossification of ligaments can improve the understanding of complex clinical neuralgias associated with this region.

A Case of Aberrant Abducens Nerve in a Cadaver and Review of Its Clinical Significance

  • Choi, Chan-Young;Han, Seong-Rok;Yee, Gi-Taek;Lee, Chae-Heuck
    • Journal of Korean Neurosurgical Society
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    • v.47 no.5
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    • pp.377-380
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    • 2010
  • The abducens nerve usually travels from the brainstem to the lateral rectus muscle as a single trunk. However, it has been reported that this nerve could split into branches occasionally. We attempted to show the aberrant course of abducens nerve in a specimen with unilateral duplicated abducens nerve and review relevant literatures. The micro-dissections were performed in a head specimen injected with colored latex under the microscope. The abducens nerve was duplicated unilaterally. This nerve emerged from the pontomedullary sulcus as a single trunk and splitted into two branches in the prepontine cistern. These two separate branches were piercing the cerebral dura of the petroclival region respectively. The slender lower branch passed between the petroclinoid and petrosphenoid ligaments and the thick lower one passed under the petrosphenoid ligament. These two branches united just lateral to the ascending segment of internal carotid artery in the cavernous sinus. The fact that there are several types of aberrant abducens nerve is helpful to perform numerous neurosurgical procedures in the petroclival region and cavernous sinus without inadvertent neurovascular injuries.

Three-Dimensional Contact Dynamic Model of the Human Knee Joint During Walking

  • Mun, Joung-Hwan;Lee, Dae-Weon
    • Journal of Mechanical Science and Technology
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    • v.18 no.2
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    • pp.211-220
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    • 2004
  • It is well known that the geometry of the articular surface has a major role in determining the position of articular contact and the lines of action for the contact forces. The contact force calculation of the knee joint under the effect of sliding and rolling is one of the most challenging issues in this field. We present a 3-D human knee joint model including sliding and rolling motions and major ligaments to calculate the lateral and medial condyle contact forces from the recovered total internal reaction force using inverse dynamic contact modeling and the Least-Square method. As results, it is believed that the patella, muscles and tendon affect a lot for the internal reaction forces at the initial heel contact stage. With increasing flexion angles during gait, the decreasing contact area is progressively shifted to the posterior direction on the tibia plateau. In addition, the medial side contact force is larger than the lateral side contact force in the knee joint during normal human walking. The total internal forces of the knee joint are reasonable compared to previous studies.

Magnetic Resonance Imaging Analysis of Biological Ligament Healing after Suture-Tape Augmentation for Chronic Lateral Ankle Instability (봉합테이프를 이용한 발목 외측인대 보강술이 생물학적 인대 재생에 미치는 영향)

  • Cho, Byung-Ki;An, Min-Yong;Kim, Yoon-Ho;Ahn, Byung-Hyun
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.3
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    • pp.117-125
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    • 2021
  • Purpose: The aim of this study was to evaluate biological ligament healing quantitatively after suture-tape augmentation for chronic lateral ankle instability. Materials and Methods: Thirty-two patients underwent magnetic resonance imaging (MRI) at a minimum of 2 years after lateral ligament augmentation using suture-tape. Signal/noise ratios (SNRs) and widths of anterior talofibular ligaments (ATFLs) were measured on preoperative and postoperative MRI by three researchers. ATFL biological healing degrees were analyzed using changes in SNRs and widths of ATFLs and by comparing these metrics with those of normal contralateral ankles. Clinical evaluations were performed using foot and ankle outcome scores (FAOSs), Foot and Ankle Ability Measure (FAAM) scores, and ankle stress radiographs. Results: Mean FAOS and FAAM scores improved significantly from 62.4 to 93.6 and 58.3 to 92.3, respectively, at final follow-up (p<0.001). Mean SNRs and ATFL widths improved insignificantly from 8.49 to 8.21 and 2.07 to 2.15 mm, respectively, at final follow-up (p=0.424, p=0.718). Significant differences in mean SNRs and ATFL widths were found between ipsilateral and contralateral sides (p<0.001, p=0.002). Spearman's correlation analysis revealed no significant association between clinical outcomes and degrees of biological healing of ATFLs based on MRI findings. Conclusion: Despite improvements in clinical outcome measures, the effects of suture-tape augmentation for chronic lateral ankle instability on biological ligament healing were insignificant. In addition, no significant correlation was found between clinical outcomes and degrees of biological healing of ATFLs.

Preservation of the Posterior Ligaments for Preventing Postoperative Spinal Instability in Posterior Decompression of Lumbar Spinal Stenosis: Comparative Study between Port-Hole Decompression and Subtotal Laminectomy (요추부 척추관 협착증의 후방 감압술에서 후방 인대의 보존 여부와 술 후 척추 불안정성과의 연관성: 포트홀(Port-Hole) 감압술과 후궁 아전절제술 간 비교 연구)

  • Jung, Yu-Hun;Na, Hwa-Yeop;Choe, Saehun;Kim, Jin;Lee, Joon-Ha
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.71-77
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    • 2020
  • Purpose: To determine if sparing the interspinous and supraspinous ligaments during posterior decompression for lumbar spinal stenosis is significant in preventing postoperative spinal instability. Materials and Methods: A total of 83 patients who underwent posterior decompression for lumbar spinal stenosis between March 2014 and March 2017 with a minimum one-year follow-up period, were studied retrospectively. The subjects were divided into two groups according to the type of surgery. Fifty-six patients who underwent posterior decompression by the port-hole technique were grouped as A, while 27 patients who underwent posterior decompression by a subtotal laminectomy grouped as B. To evaluate the clinical results, the Oswestry disability index (ODI), visual analogue scale (VAS) for both back pain (VAS-B) and radiating pain (VAS-R), and the walking distance of neurogenic intermittent claudication (NIC) were checked pre- and postoperatively, while simple radiographs of the lateral and flexion-extension view in the standing position were taken preoperatively and then every six months after to measure anteroposterior slippage (slip percentage), the difference in anteroposterior slippage between flexion and extension (dynamic slip percentage), angular displacement, and the difference in angular displacement between flexion and extension (dynamic angular displacement) to evaluate the radiological results. Results: The ODI (from 28.1 to 12.8 in group A, from 27.3 to 12.3 in group B), VAS-B (from 7.0 to 2.6 in group A, from 7.7 to 3.2 in group B), VAS-R (from 8.5 to 2.8 in group A, from 8.7 to 2.9 in group B), and walking distance of NIC (from 118.4 m to 1,496.2 m in group A, from 127.6 m to 1,481.6 m in group B) were improved in both groups. On the other hand, while the other radiologic results showed no differences, the dynamic angular displacement between both groups showed a significant difference postoperatively (group A from 6.2° to 6.7°, group B from 6.5° to 8.4°, p-value=0.019). Conclusion: Removal of the posterior ligaments, including the interspinous and supraspinous ligaments, during posterior decompression of lumbar spinal stenosis can cause a postoperative increase in dynamic angular displacement, which can be prevented by the port-hole technique, which spares these posterior ligaments.