• Title/Summary/Keyword: Lateral-superior

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최소침습적 금속판 내고정술을 이용한 전위된 관절 내 종골 골절의 임상적 치료결과 (Clinical Results of Surgical Treatment with Minimally Invasive Percutaneous Plate Osteosynthesis for Displaced Intra-articular Fractures of Calcaneus)

  • 서재완;양종헌;박현우
    • 대한족부족관절학회지
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    • 제24권2호
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    • pp.87-93
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    • 2020
  • Purpose: This study evaluated the clinical results of surgical treatment with minimally invasive plate osteosynthesis for treating displaced intra-articular fractures of the calcaneus in comparison with conventional lateral extensile approach plate osteosynthesis. Materials and Methods: Of 79 cases of Sanders type II or III calcaneus fractures, 15 cases treated with the minimally invasive calcaneal plate (group M) and 64 cases treated with lateral extensile approach calcaneal plate (group E) were identified. After successful propensity score matching considering age, sex, diabetes mellitus history, and Sanders type (1:3 ratio), 15 cases (group M) and 45 cases (group E) were matched and the demographic, radiologic, and clinical outcomes were compared between the two groups. Results: The median time of surgery from injury was 2.0 days in group M and 6.0 days in group E (p=0.014). At the six months follow-up, group M showed results comparable with those of group E in radiographic outcomes. In the clinical outcomes, group M showed better postoperative American Orthopaedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS) scores than did group E (p=0.001, p=0.008). A greater range of subtalar motion was achieved at the six months follow-up in group M (inversion 20.0° vs. 10.0°, p=0.002; eversion 10.0° vs. 5.0°, p=0.025). Although there were no significant differences in complications between the two groups (1 [6.7%] vs. 7 [15.6%], group M vs. group E; p=0.661), there was only one sural nerve injury and no wound dehiscence and deep infection in group M. Conclusion: Minimally invasive plate osteosynthesis showed superior clinical outcomes compared with that of the conventional lateral extensile approach plate osteosynthesis in Sanders type II or III calcaneus fractures. We suggest applying minimally invasive plate osteosynthesis in Sanders type II or III calcaneus fractures.

시체 해부를 통한 다리의 얕은종아리신경 동반동맥과 앞근육사이막에 존재하는 관통가지에 관한 해부학적 연구 (Anatomical Study of Superficial Peroneal Nerve Accessory Artery and Perforators in the Anterior Intermuscular Septum of Lower Leg Using Cadaveric Dissection)

  • 김준식;신상호;최태현;이경석;김남균
    • Archives of Plastic Surgery
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    • 제33권6호
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    • pp.695-699
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    • 2006
  • Purpose: In the 1990s, skin island flap supplied by the vascular axis of the sensitive superficial nerves had been introduced. For example, neurocutaneous flaps supplied by the vascular axis of the sural nerve and saphenous nerve have been used. But the flap supplied by the vascular axis of superficial peroneal nerve has not been used commonly. Because there have been few anatomical reports about the superficial peroneal nerve accessory artery(SPNAA), we could not apply the neurocutaneous flap supplied by SPNAA. The aim of this study is to investigate the anatomy of SPNAA, number and location of its perforators, and septocutaneous perforators from the anterior tibial artery in anterior intermuscular septum. Methods: So, we dissected a total of eight cadavers. Measurements were made of the positions of the dissected arteries and perforators from the head of the fibula. Results: In all cadavers the superior lateral peroneal artery was originated from the anterior tibial artery and contributed SPNAA. Arising from the anterior tibial artery an average of 5.63 cm inferior to the fibular head, it varied from 10 cm to 16 cm in length. SPNAA gave off an average of 4.38 perforators to supply lateral aspect. In one case the inferior lateral peroneal artery was present and arose from the anterior tibial artery 18 cm inferior to the fibular head. There were an average of 3.38 direct septocutaneous perforators from the anterior tibial artery. Conclusion: Septocutaneous perforators from SPNAA mainly exist from proximal 1/6 to 3/5 of lower leg. In the distal 1/3 of lower leg where the accessory artery was disappeared, exist mainly direct septocutaneous perforators from the anterior tibial artery. Our results can be helpful to applications of the neurocutaneous flap using SPNAA or fasciocutaneous flap based on direct septocutaneous perforators.

The Versatility of Cheek Rotation Flaps

  • Kim, Kyung Pil;Sim, Ho Seup;Choi, Jun Ho;Lee, Sam Yong;Lee, Do Hun;Kim, Seong Hwan;Kim, Hong Min;Hwang, Jae Ha;Kim, Kwang Seog
    • 대한두개안면성형외과학회지
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    • 제17권4호
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    • pp.190-197
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    • 2016
  • Background: The cheek rotation flap has sufficient blood flow and large flap size and it is also flexible and easy to manipulate. It has been used for reconstruction of defects on cheek, lower eyelid, or medial and lateral canthus. For the large defects on central nose, paramedian forehead flap has been used, but patients were reluctant despite the remaining same skin tone on damaged area because of remaining scars on forehead. However, the cheek flap is cosmetically superior as it uses the adjacent large flap. Thus, the study aims to demonstrate its versatility with clinical practices. Methods: This is retrospective case study on 38 patients who removed facial masses and reconstructed by the cheek rotation flap from 2008 to 2015. It consists of defects on cheek (16), lower eyelid (12), nose (3), medial canthus (3), lateral canthus (2), and preauricle (2). Buccal mucosa was used for the reconstruction of eyelid conjunctiva, and skin graft was processed for nasal mucosa reconstruction. Results: The average defect size was $6.4cm^2$, and the average flap size was $47.3cm^2$. Every flap recovered without complications such as abnormal slant, entropion or ectropion in lower eyelid, but revision surgery required in three cases of nasal side wall reconstruction due to the occurrence of dog ear on nasolabial sulcus. Conclusion: The cheek rotation flap can be applicable instead of paramedian forehead flap for the large nasal sidewall defect reconstruction as well as former medial and lateral canthal defect reconstruction.

정상성인에서 정적 균형 제어 시 다양한 조건에 따른 하퇴 근육 활성도의 특성 (Electromyographic Activities of Lower Leg Muscles During Static Balance Control in Normal Adults)

  • 우영근;박지원;최종덕;황지혜;김연희
    • 한국전문물리치료학회지
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    • 제11권2호
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    • pp.35-45
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    • 2004
  • The purpose of this study was to investigate the correlation and characteristics between electromyographic (EMG) activities of lower leg muscles and the posturographic assessment of static balance control in normal adults. Twenty-four young, healthy adults(12 males, 12 females) participated in the study. Center of pressure (COP) parameters were obtained using force platform as total path distance, total sway area, X mean frequency and Y mean frequency for 20 seconds in the following conditions: (1) comfortable standing with eyes opened or closed, (2) uncomfortable standing (feet together) with eyes opened or closed, (3) virtual moving surround delivered using Head mount display (HMD) with four different moving patterns. The virtual moving patterns consisted of close-far, superior-inferior tilting (pitch), right-left tilting (roll), and horizontal rotation (yaw) movements. Surface electromyographic activites were recorded on the tibialis anterior, peroneus longus, medial and lateral heads of gastrocnemius muscles under each condition. Correlation between the posturographic measures and EMG activities were evaluated. Total path distance and total sway area of COP were significantly increased during uncomfortable standing. EMG activity of tibialis anterior was significantly more during uncomfortable standing and virtual moving surround stimulation than during comfortable standing. Total path distance and sway area of COP during comfortable standing with closed eyes showed significant positive correlation with the EMG activities of the lateral head of gastrocnemius muscle. Total path distances and total sway area of COP during muscle. Total path distances and total sway area of COP during presentation of virtual moving surround also had significant positive correlations with EMG activities of the lateral head of gastrocnemius muscle under close-far movement.

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개방교합자의 설근과 구륜근 활성도에 관한 연구 (AN ELECTROMYOGRAGHIC STUDY OF MUSCULAR ACTIVITIES OF TONGUE AND LIP MUSCLES IN ANTERIOR OPEN-BITE)

  • 최연석;이기수;박영국
    • 대한치과교정학회지
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    • 제24권2호
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    • pp.233-246
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    • 1994
  • The purpose of the present study was to investigate the difference of muscular activities of the tongue and lip muscles between anterior open-bite and normal occlusion during various function. Thirty eight subjects of 12.1-39.6 years were employed in this study : Eighteen subjects were anterior open-bites and tweenty subjects were normal occlusions. During rest position, maximum effort of lip sealing, command swallow of saliva and sucking & swallowing of juice, the electromyographic datas of the genioglossus, superior longitudinal muscle of tongue, upper and lower orbicularis oris were recorded and integrated with Medelec MS 25 electromyographic machine. Lateral cephalometric radiographs were taken on all subjects for the analysis of tongue posture and size. All data were recored and statistically processed. The findings of this study can be summerized as follows : 1. During the rest position, muscular activity of tongue was higher than that of lip muscle in open-bite, but no difference in normal occlusion group. 2. During the swallowing of juice, the activity of orbicularis oris was higher than that of genioglossus in open-bite. But the normal occusion was showed higher activity of tongue during the swallowing of juice. 3. The open-bite, compared to the normal occlusion, had higher value of tongue muscle activity during the rest position. 4. Compared to normal occlusion group, the open-bite had higher value of lip muscle activity during the sucking and swallowing of juice. 5. During the command swallow of saliva, the normal occlusion was showed harmonious swallowing pattern, but the open-bite showed much variation and disharmony in muscular contraction sequence, tended to absent of lip muscle activity. 6. At the lateral cephalometric radiographs, compared to the normal occlusion, the open-bite was showed lower tongue posture. But no difference was found in intermaxillary space. It is suggested that the open-bite, compared to the normal occlusion, had higher muscular activity of tongue during the rest position and various functions, showed lower tongue posture on the lateral cephalogram. In the development of anterior open-bite malocclusion, these factors may be an etiologic factor.

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Diffusion Tensor Imaging of the Lateral Pterygoid Muscle in Patients with Temporomandibular Joint Disorders and Healthy Volunteers

  • Simin Liu;Changhua Wan;Haosen Li;Weiwei Chen;Chu Pan
    • Korean Journal of Radiology
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    • 제23권2호
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    • pp.218-225
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    • 2022
  • Objective: This study aimed to explore the feasibility of functional evaluation of the lateral pterygoid muscle (LPM) using diffusion tensor imaging (DTI) in patients with temporomandibular joint disorders (TMDs). Materials and Methods: A total of 119 patients with TMD (23 male and 96 female; mean age ± standard deviation, 41 ± 15 years; 58 bilateral and 61 unilateral involvements for a total of 177 joints) and 20 healthy volunteers (9 male and 11 female; 40 ± 13 years; 40 joints) were included in this prospective study. Based on DTI of the jaw in the resting state, the diffusion parameters, apparent diffusion coefficient (ADC), fractional anisotropy (FA), λ1, λ2, and λ3 of the superior and inferior heads of the LPM (SHLPM and IHLPM) were measured. Patients with TMD with normal disc position (ND), anterior disc displacement with reduction (ADWR), and anterior disc displacement without reduction (ADWOR) were compared. Results: Patients with TMD overall, and ADWR and ADWOR subgroups had significantly higher ADC, λ1, λ2, and λ3 in both the SHLPM and IHLPM than those in volunteers (p < 0.05 for all), whereas the ND subgroup only had significantly higher ADC and λ1 (p < 0.001). Meanwhile, significant differences in FA in the SHLPM and IHLPM were found between volunteers and ADWOR (p = 0.014 and p = 0.037, respectively). Among the three TMD subgroups, except for λ3 and FA in the ADWR subgroup, ADWR and ADWOR subgroups had significantly higher ADC, λ1, λ2, and λ3 and lower FA than those in the ND group (p < 0.050). There was no significant difference in diffusion variables between ADWR and ADWOR. In ADWOR, the osteoarthritis group had significantly higher λ3 and lower FA values in the IHLPM than those in the non-osteoarthritis group. Conclusion: DTI successfully detected functional changes in the LPM in patients with TMD. The unsynchronized diffusivity changes in the LPM in different subgroups of TMD signified the possibility of using diffusion parameters as indicators to identify the severity of LPM hyperfunction at various stages of TMD.

전동차 현가구조에 따른 동적거동특성 분석 (Analysis on the Dynamic Behavior according to Suspension Structure of the Urban Railway Vehicle)

  • 허현무;노학락
    • 한국산학기술학회논문지
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    • 제21권11호
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    • pp.617-623
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    • 2020
  • 다수의 승객을 운송하는 도시철도 전동차는 도시 철도교통시스템의 핵심이다. 따라서 차량의 동적성능이 확보가 차량 안전 확보 및 승객서비스 차원에서 선행되어야 한다. 철도차량의 진동, 승차감과 같은 동적거동은 현가시스템 구조 및 현가요소에 따라 크게 영향을 받는다. 철도차량의 현가시스템은 윤축과 대차간 1차현가시스템, 대차와 차체간 2차현가시스템으로 구성되어 있다. 본 논문에서는 국내에서 운용되고 있는 전동차 현가구조에 따른 전동차의 동적거동에 대하여 분석하고자 한다. 현가구조가 상이한 2종류의 전동차에 대하여 실제 선로에서 동일 주행조건으로 주행시험을 수행하였으며 차량의 진동을 계측하였고 진동과 승차감, 진동감쇠율과 같은 동적거동 특성을 분석하였다. 시험결과, 차체 진동성능은 좌우방향은 B대차가, 상하방향은 A대차가 상대적으로 우수하게 나타났다. 승차감은 전반적으로 A대차가 B대차에 비하여 우수하게 나타났다. 진동감쇠율을 보면, 1차현가시스템은 고무스프링이 적용된 A대차에 비하여 코일스프링이 적용된 B대차의 진동감쇠 성능이 우수하며 2차현가시스템은 코일스프링에 비하여 공기스프링이 적용된 A대차의 진동감쇠 성능이 우수하다. 본 논문의 결과는 향후 철도차량 신차 설계 과정에서 현가구조 설계 및 현가요소 선정 시, 유용한 자료로 활용될 것이라 기대된다.

A Novel Method to Measure Superior Migration of the Humeral Head: Step-off of the C-line

  • Park, Kyoung Jin;Eun, Hyeon Jun;Kim, Yong Min;Yoo, Jun Il;Lim, Chae Ouk
    • Clinics in Shoulder and Elbow
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    • 제19권3호
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    • pp.125-129
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    • 2016
  • Background: Superior migration of humeral head has been conventionally determined by measuring the acromiohumeral distance (AHD), We sought to devise a novel measurement system more reliably and accurately than AHD. We described a structural landmark called 'C-line'. In this study, we investigated the clinical usefulness of 'step-off of the C-line (SOC)' compared to that of AHD. Methods: The C-line formed from the medial margin of the proximal humeral head continuing up to the inferior margin of the articular glenoid and then to the lateral border of the scapula. The superior migration of the humeral head triggered by a rotator cuff tear introduces a discontinuity in this C-line. We measured the distance of this discontinuity. We enrolled 144 patients who underwent a rotator cuff repair. We selected 58 controls who didn't have any cuff lesions apparent on magnetic resonance imaging. Using radiographs derived from standardized true anteroposterior views of the shoulder, we measured the SOC and the AHD. We used t-tests for statistical analyses. Results: A rotator cuff tear was associated with an increase in SOC and a decrease in AHD. In control group, the mean SOC was $1.29{\pm}1.71mm$ and AHD was $9.71{\pm}2.65mm$. In cuff tear group, the mean SOC was $3.15{\pm}3.41mm$ and AHD was $8.28{\pm}1.76mm$. The mean SOCs of the patient group in relation to the mean SOC of the control group according to tear size, the SOCs of medium tear and lager groups showed statistically significant increase (p<0.05). Conclusions: The SOC may be a similarly effective to diagnose cuff tears of medium size and larger compared with AHD.

양측성 상대정맥 기형을 동반한 기관성 기관지 1예 (A Case of Tracheal Bronchus Associated with Bilateral Superior Vena Cava Anomaly)

  • 정재희;박무석;김희만;박정탁;정재호;최병욱;김영삼;장준;김성규;김세규
    • Tuberculosis and Respiratory Diseases
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    • 제53권3호
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    • pp.337-343
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    • 2002
  • 저자들은 어렸을 때부터 간헐적인 호흡곤란이 있어 기관지 천식으로 치료를 받아온 과거력이 있는 20세 남자에서 군입대 신체검사를 위해 시행한 흉부전산화단층촬영과 굴곡성 기관지내시경 검사상 우연히 발견된 양측성 상대정맥 기형을 동반한 기관성 기관지 1예를 경혐하였기에 문헌 고찰과 함께 보고하는 바이다.

두부(頭部) X-선(線) 규격사진법(規格寫眞法)에 의(依)한 한국인(韓國人) 하수체와(下垂體窩)의 형태학적(形態學的) 연구(硏究) (The Morphological Standards of Sella Turcica by Means of Roentgeno-Cephalometric Analysis)

  • 장익태
    • 대한치과보철학회지
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    • 제8권1호
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    • pp.85-89
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    • 1968
  • The author has carried out the statistical standards on liner and angular measurements of sells turcica in 244 normal Korean of various age group by means of lateral cephalometric radiography. The results were as follows; 1. The linear measurements between Ant-Post distance and distance from the tip of tuberculum of sellae to posterior clinoid process were obtained 14.81mm, 9.85mm in the age of 5 years old male and 14.44mm, 9.52mm in female, respectively. There was no outstanding difference with age, but more predominant in female than male. 2. The linear measurements of inferior depth show somewhat increases but no changes in superior depth. 3. It has been showed that the greatest width revealed significant increment beyond 15 years old of both sexes in Korean. 4. None of the significant difference in angular measurement was found with age, but angulation for dorsum sellae decreased after 15 years of male. 5. Generally speaking, increment rates of female in each items were greater than male.

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