• 대한족부족관절학회지
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• 제28권1호
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• pp.1-7
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• 2024

Despite the advances in total ankle replacement (TAR), TAR has emerged as a promising alternative to ankle arthrodesis, particularly in severe ankle arthritis. Restoring ankle stability and alignment is the most important technical consideration and the goal of TAR. Hence, additional procedures, such as soft tissue balancing and osteotomies, are often critical parts of surgical planning. This article reviews the basics of joint balancing, offering suggestions on procedure selection for ligamentous balancing and varus and valgus malalignment in TARs.

• Journal of Korean Neurosurgical Society
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• 제29권1호
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• pp.58-65
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• 2000

Objective : Thoracolumbar junction is second most common level of injury next to cervical spine. The object of this study is to study the usefulness of surgical titanium mesh instead of bone graft, as well as to evaluate the correction of spinal deformity and safety of early ambulation in patients with injury at thoracolumbar junction. Patients and Methods : This review included 51 patients who were operated from July 1994 to December 1997. The injured spine is considered to be unstable, if it shows involvement of two or more columns, translatory displacement more than 3.5mm, decrease more than 35% in height of vertebral body and progression of malalignment in serial X-ray. The decision to operate was determined by (1) compression of spinal cord or cauda eguina, (2) unstable fracture, (3) malalignment and (4) fracture dislocation. The procedure consisted of anterior decompression through corpectomy and internal fixation with anterior instrument and surgical titanium mesh which was impacted with gathered bone chip from corpectomy. Results : Fifty-one patients were followed up for at least 12 months. The main causes of injury were fall and vehicle accident. The twelfth thoracic and the first and the second lumbar vertebrae were frequently involved. Complete neural decompression was possible under direct vision in all cases. Kyphotic angulation occurred in a patient. Radiologic evaluation showed correction of deformity and no distortion or loosening of surgical titanium mesh with satisfactory fixation postoperatively. Conclusions : We could obtain neurological improvement, relief of pain, immediate stabilization and early return to normal activities postoperatively. Based on these results, authors recommend anterior decompression and internal fixation with surgical titanium mesh in thoracolumbar unstable spine injuries.

• 한국정밀공학회:학술대회논문집
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• 한국정밀공학회 2005년도 춘계학술대회 논문집
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• pp.881-887
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• 2005

A total knee replacement is an extremely 'position-sensitive' operation; a malposition or a malalignment of the components will lead to a breakage of the component, a fracture around the knee prosthesis, and the limitation of range of the motion, etc. In a conventional total knee replacement, surgeons have to select an appropriate prosthesis according to the shape of the surgical region. A wrong selection may give rise to side effects or to need re-operation. Nevertheless, it is so difficult to choose the most proper prosthesis out of various kinds of prosthesis. This paper presents a surgical planning system for the total knee replacement with an operation simulating method in order to determine the parameters for the total knee replacement operation. We select an alignment axis and a resection angle as major operation parameters in the total knee replacement operation, and introduce the method to determine the major operation parameters with the operation simulator we developed. The simulator is used to determine operation parameters for optimized operations, to select the most appropriate prosthesis, and to analyze the prospective problems of the operation.

• 대한정형외과스포츠의학회지
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• 제7권2호
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• pp.75-83
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• 2008

과사용 증후군은 정상적인 조직에 최대하 부하(submaximal stress)가 지속되어 발생하는 것이다. 이와 같은 현상은 연부조직의 접합부(junction)에서 주로 일어나며 힘의 전달이 집중되는 곳, 조직의 역학적 성질이 변화되는 곳, 그리고 성장시 빨리 변화하는 성질이 있는 곳에 주로 생긴다. 근육의 불균형이 과사용 증후군의 가장 많은 원인이다. 과거의 부상 이후 부적절한 재활치료 및 각형성 또는 회전 부정정렬(angular and rotational malalignment) 등이 과사용 증후군의 원인이 될 수 있다. 스포츠 훈련 방법의 실수로도 과사용 증후군이 생길 수 있다. 전방 슬관절 동통시 감별해야 할 질환들은 jumper's knee, 슬개건염 혹은 대퇴 사두건염, Osgood-Schlatter 병, Sinding-Larsen-Johansson 병, 슬개골 연골 연화증, 슬개골 전(prepatellar) 혹은 슬개골 하(infrapatellar) 점액낭염, Hoffa's fat pad의 염증, 그리고 특발성 전방 슬관절 동통 증후군(idiopathic anterior knee pain syndrome)등이 있다. 후방 슬관절 통증의 원인 질환으로는 만성 슬와근 염좌, 슬괵건 점액낭염, 경골 골간단의 피로 골절 등이 포함되며 외측 슬관절 통증의 원인으로는 장경대 충돌 증후군(iliotibial band friction syndrome)등이 있을 수 있다. 이외 과사용 증후군과 관련된 슬관절 통증의 원인으로 다분 슬개골(multipartite patella), 내측 경골 스트레스 증후군(medial tibial stress syndrome), 박리성 골연골염, 반월상 연골의 퇴행성 변화 등이 있을 수 있다. 과사용 증후군의 진단 및 치료의 일반적인 접근법은 다섯가지 단계의 프로그램으로 요약될 수 있다. 첫째, 원인 요소를 확인하고, 둘째, 요소를 변경시키고, 셋째, 통증을 조절하고, 넷째, 능동적 재활을 시키고, 그리고 다섯째, 유지시키는 것이다.

• 대한치과교정학회지
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• 제2권1호
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• pp.47-52
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• 1971

저자들은 9세 10개월된 Class I discrepancy 증례를 다각적으로 검사한 후 그의 가족력과 Grater. Nance, Mills, Lloyd, Dewe, 등의 생각대로 Clinical arch lenth의 증가를 더 기대할수 없다고 판단하고 연속발치를 시술하여 전치부의 교우교합과 총생이 거의 해소되어 좋은결과를 보이고 있으나, 두부X-선 규격 사진분석에서 보는바와 같이 Interincisal angle이 약간 크므로 향후 예견되는 Deep Overbite와 Incisal Inclination Control에 치료의 역점를 두고자한다.

• 대한족부족관절학회지
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• 제10권2호
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• pp.140-143
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• 2006

Purpose: To present tibial axis-talar ratio and tibia-ankle surface angle in lateral measured on standing ankle lateral radiographs of adults who did not have specific ankle pathology. Materials and Methods: On Fifty-six radiographs without ankle osteoarthritis and malalignment, radiographic measures were performed with use of a custom dizitizing program based on $PV-WAVE^{(R)}$. AP ankle alignment was quantified by tibia axis-talar ratio (TTR) and tibia ankle surface angle in lateral (TLS angle). The data was compared with previously reported american data and analyzed using a t-test. Results: The average TTR and TLS angle of our series were $33.9{\pm}3.3%$, and no significant difference compared with reported american adults (p=0.152). Conclusion: The T-T ratio and TLS angle measured on standing ankle lateral radiographs of our series were $33.9{\pm}3.3%$ and $80.4{\pm}3.3^{\circ}$. This measures appear to be a useful measure for determining AP ankle alignment.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1997년도 추계학술대회
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• pp.369-372
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• 1997

Socket pressure distributions with gait analyses of a transfemoral and a transtibial prostheses were measured in order to assess an optimal socket fitting and unction. Ankle joint was aligned by the neutral and the dorsi/plantar flexed positions. Compared to dorsi and plantar flexed positions of ankle joint, cadence and walking speed increased with the neutral ankle joint alignment. Other gait parameters were close to the normative data with the neutral ankle joint alignment. For the transfemoral amputee, dorsiflexed alignment of the ankle joint created high pressure on the lateral aspect of the socket, on the other hand, plantarflexed alignment resulted in increased pressure on the medial aspect of the socket. For the transtibial amputee, dorsiflexed alignment of the ankle resulted in high pressure on the antero-lateral aspect of the socket during mid-stance, but plantarflexion of the ankle joint showed slight increases in pressure at the same location in the socket. The present study clearly demonstrated that malalignment of a prosthesis results in localized increasing pressure within the socket. Proper alignment of the prosthesis is required in order to acquire an appropriate socket-limb interface as well as the proper gait.

• 대한소아치과학회지
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• 제24권4호
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• pp.758-762
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• 1997

There are various types of localized tooth malpositions in the mixed dentition, such as abnormal tooth axis, anterior crossbite of some incisors, impaction, midline diastema, ectopic eruption, and so forth. We, Pediatric Dentists, have usually used removable appliances for these instances. But, removable orthodontic appliances, as is known, have marked limitations in some situations, for example, severe rotation, intrusion and extrusion, root torque, closure of large diastema, traction of impacted tooth, etc. In such cases, Whip spring, combined with fixed or removable appliance, can increase utilities of removable orthodontic appliances. The authors have applied whip springs to some cases showing localized positional and arrangement problems, and have witnessed the results as follows; 1. The refined and elaborate control of direction and magnitude of force by the operator, and accurate compliance of the patients were requisite for the treatment with it. 2. It showed special effectiveness for de rotation of incisors. Although it yields some benefit for root movement, the special consideration for incomplete roots in this age bracket was required. 3. In the localized malalignment cases in mixed dentition, uncurable with traditional removable appliances but practically unrealistic with fixed appliance therapy, the whip spring was thought to be a good alternative.

• 대한물리치료과학회지
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• 제26권1호
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• pp.9-14
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• 2019

Background: Pes planus, or flat foot, causes lower limb malalignment and foot pain during walking or exercise. Therefore, a highly reliable evaluation method to accurately diagnose flat feet is necessary. This study investigated the intra-and inter-rater reliability of the navicular drop test in different postures. Design: Cross sectional study. Methods: Forty healthy volunteers performed the navicular drop test in three different combinations of non-weight-bearing and weight-bearing postures (standing/standing, sitting/sitting, and sitting/standing). Two examiners alternately performed the measurements five times in each subject, and in each posture. Significant differences in measurements were obtained among the three postures, with the highest navicular drop being observed in the sitting/standing posture. Results: Inter-rater reliability was high in the sitting/standing and sitting/sitting postures. Intra-rater reliability was high in all three postures. In the sitting/sitting and sitting/standing postures, large navicular drop values and high inter- and intra-rater reliability were observed. Conclusion: Therefore, the sitting/standing and sitting/sitting postures are recommended for use in navicular drop tests to diagnose flat feet.

• 대한족부족관절학회지
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• 제27권2호
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• pp.71-74
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• 2023

A medial opening wedge supramalleolar osteotomy (SMO) introduced by Takakura et al. is a useful realignment procedure for patients with ankle joint arthritis and varus malalignment by shifting the weight-bearing axis laterally and redistributing the loads on the ankle joint. When pain persists after arthroscopic microfracture in patients with medial osteochondral lesion of the talus (OLT), redo arthroscopy, osteochondral autograft transplantation, autologous chondrocyte implantation, or matrix-induced chondrogenesis might be indicated. On the other hand, there is insufficient scientific evidence for realignment surgery through SMO, while the effect of realignment surgery has been studied consecutively for osteochondral lesions of the knee. Therefore, this paper reports a patient with medial OLT who underwent redo arthroscopy combined with SMO for persistent pain after primary arthroscopic microfracture.