• Title/Summary/Keyword: Limb-length discrepancy

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Effects of Iyengar Yoga Practice for 12 weeks on Lower Body Imbalance in Middle-aged Women (중년여성의 12주간 아헹가 요가 수련이 하체 불균형에 미치는 영향)

  • Park, Yunha;Kim, Donghee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.1
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    • pp.431-440
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    • 2017
  • The purpose of this study was to investigate the effects of Iyengar yoga practice on the lower body imbalance in middle-aged women. The subjects (n=24), who had not performed yoga training prior to this study (and) were not attending any other training programs, participated after undergoing an X-RAY examination with the Gonstead Technique and then their lower body imbalance (was reevaluated). The subjects completed the yoga program for 12 weeks (3 times per week, 90 minutes per session). The data were analyzed with the paired t-test and alpha was set at 0.05. It was found that 1) the height differences between the right and left iliac crests (p < 0.001), width (p < 0.001) and length (p < 0.001) differences between the right and left iliac fossa, and width differences between the right and left sacrum (p < 0.001) were significantly reduced after the training program. In addition, 2) the lower limb length discrepancy was significantly reduced (p < 0.001). Our data suggest that Iyengar yoga training for 12 weeks reduces the pelvic imbalance and length differences between the right and left lower limbs in middle-aged females.

Effects of Artificial Leg Length Discrepancies on the Dynamic Joint Angles of the Hip, Knee, and Ankle During Gait

  • Kim, Yong-Wook;Jo, Seung-Yeon;Byeon, Yeoung-In;Kwon, Ji-Ho;Im, Seok-Hee;Cheon, Su-Hyeon;Kim, Eun-Joo
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.1
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    • pp.53-61
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    • 2019
  • PURPOSE: This study examined the dynamic range of motion (ROM) of the hip, knee, and ankle joint when wearing different shoe sole lifts, as well as the limb asymmetry of the range according to the leg length discrepancy (LLD) during normal speed walking. METHODS: The participants were 40 healthy adults. A motion analysis system was used to collect kinematic ROM data. The participants had 40 markers attached to their lower extremities and were asked to walk on a 6 m walkway, under three different shoe lift conditions (without an insole, 1 cm insole, and 2 cm insole). Visual3D professional software was used to coordinate kinematic ROM data. RESULTS: Most of the ROM variables of the short limbs were similar under each insole lift condition (p>.05). In contrast, when wearing a shoe with a 2 cm insole lift, the long limbs showed significant increases in flexion and extension of the knee joint as well as; plantarflexion, dorsiflexion, pronation, eversion, and inversion of the ankle joint (p<.05). Of the shoes with the insole lifts, significant differences in all ROM variables were observed between the left and right knees, except for the knee internal rotation (p<.05). CONCLUSION: As the insole lift was increased, more ROM differences were observed between the left and right limbs, and the asymmetry of the bilateral lower limbs increased. Therefore, appropriate interventions for LLD are needed because an artificial mild LLD of less than 2.0 cm could lead to a range of musculoskeletal problems of the lower extremities, such as knee and ankle osteoarthritis.

Low Tibial Osteotomy (저위 경골 절골술)

  • Choi, Jun Young;Suh, Jin Soo
    • Journal of Korean Foot and Ankle Society
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    • v.18 no.4
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    • pp.141-146
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    • 2014
  • Low tibial osteotomy is an extra-articular procedure that realigns the mechanical axis, restoring ankle function. It is also an alternative surgical procedure to manage early osteoarthritis of the ankle joint. This can mainly address ankle varus/valgus, as well as procurvatum/ recurvatum, internal/external rotation, equinus, calcaneus, and limb length discrepancy. The authors describe the history, mechanism, indications, and limitations of low tibial osteotomy focused on osteoarthritis of the ankle with varus malalignment reviewing several articles published thus far.

Treatment of Forearm Deformity caused by Hereditary Osteochondromatosis using Free Vascularized Fibular Epiphyseal Transplantation (생비골 성장판 이식술을 이용한 선천성 다발성 골연골증에서 전완부 변형의 치료)

  • Han, Chung-Soo;Yoo, Myung-Chul;Chung, Duke-Whan;Han, Hyun-Soo;Han, Soo-Hong
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.1
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    • pp.60-67
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    • 1995
  • It is difficult to manage the growing deformity of forearm bone caused by hereditary osteochondromatosis in children, because deformity and discrepancy of limb length is progressive. The are many treatment methods of these problems including excisio of osteochondroma, lengthening of ulna, shortening of radius, corrective osteotomy with or without lengthening apparatus. Among many treatment methods, we tried free vascularized epiphyseal transplantation with the proximal fibular epiphysis in 3 patients of hereditary osteochondromatosis for inducement of continuous bone growth and deformity correction. The average duration of follow up was 7 years and 1 month, the shortest duration being to 4 years and 5 months and the longest 10 years and 8 months. Serial radiologic and clinical evaluation were carried out during follow up and there were satisfactory length gain, deformity correction and improvement of adjacent joint motion in 2 cases. According to our follow up evaluation, free vascularized epiphyseal transplantation is valuable procedure in forearm deformity of hereditary osteochondromatosis although it needs skillful and experienced operative technique.

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Percutaneous screw fixation and external stabilization as definitive surgical intervention for a pelvic ring injury combined with an acetabular fracture in the acute phase of polytrauma in Korea: a case report

  • Hohyoung Lee;Myung-Rae Cho;Suk-Kyoon Song;Euisun Yoon;Sungho Lee
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.298-303
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    • 2023
  • Unstable pelvic ring injuries are potentially life-threatening and associated with high mortality and complication rates in polytrauma patients. The most common cause of death in patients with pelvic ring injuries is massive bleeding. With resuscitation, external fixation can be performed as a temporary stabilization procedure for hemostasis in unstable pelvic fractures. Internal fixation following temporary external fixation of the pelvic ring yields superior and more reliable stabilization. However, a time-consuming extended approach to open reduction and internal fixation of the pelvic ring is frequently precluded by an unacceptable physiologic condition and/or concomitant injuries in patients with multiple injuries. Conservative treatment may lead to pelvic ring deformity, which is associated with various functional disabilities such as limb length discrepancy, gait disturbance, and sitting intolerance. Therefore, if the patient is not expected to be suitable for additional surgery due to a poor expected physiologic condition, definitive external fixation in combination with various percutaneous screw fixations to restore the pelvic ring should be considered in the acute phase. Herein, we report a case of unstable pelvic ring injury successfully treated with definitive external fixation and percutaneous screw fixation in the acute phase in a severely injured polytrauma patient.

The Comparative Study between Leg Length Analysis and X-ray on Diagnosis of Pelvic Malpositions - according to Positions and Valuation Bases - (기능성 족지장단분석과 X-ray의 골반변위 진단의 비교 연구 - X-ray 촬영 자세 및 평가 기준에 따라 -)

  • Lee, Jung-Min;Koog, Gil-Ho;Choi, Bo-Mi;Jeong, Hyun-A;Hong, Seo-Young
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.5 no.2
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    • pp.169-180
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    • 2010
  • Objectives: This study was carried out to investigate the relationship of leg length analysis and X-ray finding according to positions and valuation bases on diagnosis of pelvic malpositions. Methods: Twenty-two people who get $33.09{\pm}10.73$ as average were evaluated by leg length analysis and X-ray findings. After measuring innominate measurement(IM), femur head line. distance between S2 and posterior superior iliac spine(PSIS). ilium shadow measurement(ISM), major axis of obturator foramen(MaF), minor axis of obturator foramen(MiF) and distance between off centering measurement and symphysis pubis, those were analyzed. Results: 1. In assessment of posterior rotation malposition ilium(PI), it was showed the best coincidence between leg length analysis and X-ray analyzed by 1M in supine position(11 cases, 50.5%). 2. In assessment of inflare, coincidence index between leg length analysis and X-ray were not good($4.00{\pm}3.03$ cases, $18.15{\pm}13.82%$). And leg length analysis were not sensitive. 3. On the whole, coincidence index between leg length analysis and X-ray were not good(best: 1 case, 45.5%; worst: 11 cases, 50.0%). Conclusions: Results form this investigation showed the relationship of leg length analysis and X-ray according 10 positions and valuation bases on diagnosis of pelvic malpositions. This results are expected to contribute to establish method of assessment in diagnosis of pelvic malpositions.

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Focal Muscle Vibration Changes the Architecture of the Medial Gastrocnemius Muscle in Persons With Limited Ankle Dorsiflexion

  • Moon, Il-Young;Lim, Jin-Seok;Park, Il-Woo;Yi, Chung-Hwi
    • Physical Therapy Korea
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    • v.29 no.1
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    • pp.48-53
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    • 2022
  • Background: The gastrocnemius tightness can easily occur. Gastrocnemius tightness results in gait disturbance. Thus, various interventions have been used to release a tight gastrocnemius muscle and improve gait performance. Moreover, focal muscle vibration (FMV) has recently been extensively researched in terms of tight muscle release and muscle performance. However, no study has investigated the effects of FMV application on medial gastrocnemius architectural changes. Objects: In this study, we aimed to investigate the effects of FMV on medial gastrocnemius architecture in persons with limited ankle dorsiflexion. Methods: Thirty one persons with <10° of passive ankle dorsiflexion participated in this study. We excluded persons with acute ankle injury within six months prior to study onset, a history of ankle fracture, leg length discrepancy greater than 2 cm, no history of neurological dysfunction, or trauma affecting the lower limb. The specifications of the FMV motor were as follows: a fixed frequency (fast wave: 150 Hz) and low amplitude (0.3-0.5 mm peak to peak) of vibration; the motor was used to release the medial gastrocnemius for 15 minutes. Each participant completed three trials for 10 days; a 30-second rest period was provided between each trial. Medial gastrocnemius architectural parameters [muscle thickness (MT), fiber bundle length (FBL), and pennation angle (PA)] were measured via ultrasonography. Results: MT significantly decreased after FMV application (p < 0.05). FBL significantly increased from its baseline value after FMV application (p < 0.05). PA significantly decreased from its baseline value after FMV application (p < 0.05). Conclusion: FMV application may be advantageous in reducing medial gastrocnemius excitability following a decrease in the amount of contractile tissue. Furthermore, FMV application can be used as a stretching method to alter medial gastrocnemius architecture.

Pasteurized Osteoarticular Graft for Periacetabular Sarcoma - A Case Report - (비구 주위 육종의 저온 열처리한 골연골 이식술 - 증례 보고 -)

  • Song, Won-Seok;Byun, Woo-Jin;Cho, Sang-Hyun;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.185-189
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    • 2007
  • Advancement of imaging and surgical technique makes the internal hemipelvectomy one of the routine procedures of pelvis sarcoma. However, optimal reconstructive option for skeletal defect is still controversial. Pasteurized autogenous bone-total hip composite is a biologic method and its anatomical appropriateness gives good indication for selected cases. Nevertheless, in case of complication such as infection or mechanical breakage, removal of hardware including graft is inevitable. In those cases, marked limb length discrepancy induce marked functional deficit. To overcome this problem, the authors report 1 case, refining previous technique, saving the femoral head and reinsertion of osteoarticularly pasteurized host bone.

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CURRENT REVIEW OF MOLECULAR BIOLOGY IN DISTRACTION OSTEOGENESIS (신연 골형성술에 있어서의 분자생물학적 최신 지견)

  • Jee, Yu-Jin;Song, Hyun-Chul;Kim, Yeo-Gab;Kim, Jin;Kim, Chang-Hyen
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.28 no.6
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    • pp.456-463
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    • 2002
  • Distraction osteogenesis is a well-established clinical treatment for limb length discrepancy and skeletal deformities. Appropriate mechanical tension-stress is believed not to break the callus but rather to stimulate osteogenesis. In contrast to fracture healing, the mode of bone formation in distraction osteogenesis is primarily intramembranous ossification. Although the biomechanical, histological, and ultrastructural changes associated with distraction osteogenesis have been widely described, the basic biology of the process is still not well known. Moreover, the molecular mechanisms in distraction osteogenesis remain largely unclear. Recent studies have implicated the growth factor cascade is likely to play an important role in distraction. And current reserch suggested that mechanical tension-stress modulates cell shape and phenotype, and stimulates the expression of the mRNA for bone matrix proteins. This article presents the hypotheses and current research that have furthered knowledge of the molecular biology that govern distraction osteogenesis. The gene regulation of growth factors and extracellular matrix proteins during distraction osteogenesis are discussed in this article. It is believed that understanding the biomolecular mechanisms that mediate distraction osteogenesis may guide the development of targeted strategies designed to improve distraction osteogenesis and accelerate bone healing.

Primary Arthroplasty for Unstable and Failed Intertrochanteric Fractures: Role of Multi-Planar Trochanteric Wiring Technique

  • Javahir A. Pachore;Vikram Indrajit Shah;Sachin Upadhyay;Shrikunj Babulal Patel
    • Hip & pelvis
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    • v.35 no.2
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    • pp.108-121
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    • 2023
  • Purpose: The primary objective of the current study is to demonstrate the trochanteric wiring technique. A secondary objective is to evaluate the clinico-radiological outcomes of use of the wiring technique during primary arthroplasty for treatment of unstable and failed intertrochanteric fractures. Materials and Methods: A prospective study including follow-up of 127 patients with unstable and failed intertrochanteric fractures who underwent primary hip arthroplasty using novel multi-planar trochanteric wiring was conducted. The average follow-up period was 17.8±4.7 months. Clinical assessment was performed using the Harris hip score (HHS). Radiographic evaluation was performed for assessment of union of the trochanter and any mechanical failure. P<0.05 was considered statistically significant. Results: At the latest follow-up, the mean HHS showed significant improvement from 79.9±1.8 (at three months) to 91.6±5.1 (P<0.05). In addition, no significant difference in the HHS was observed between male and female patients (P=0.29) and between fresh and failed intertrochanteric fractures (P=0.08). Union was achieved in all cases of fractured trochanter, except one. Wire breakage was observed in three patients. There were five cases of limb length discrepancy, three cases of lurch, and three cases of wire-related bursitis. There were no cases of dislocation or infection. Radiographs showed stable prosthesis in situ with no evidence of subsidence. Conclusion: Use of the proposed wiring technique was helpful in restoring the abductor level arm and multi-planar stability, which enabled better rehabilitation and resulted in excellent clinical and radiological outcomes with minimal risk of mechanical failure.