• Clinics in Shoulder and Elbow
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• 제25권4호
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• pp.328-333
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• 2022

Irreparable rotator cuffs with retracted torn ends remain a significant challenge for most shoulder surgeons. Since repairs are preferable to reconstruction or replacement whenever possible, studies for anatomical reductions with minimal tension and secure fixation are important. In this study, the authors introduce an arthroscopic supraspinatus advancement (ASSA) procedure for retracted rotator cuff tears that could not be adequately reduced to the original footprint. Using modified long, narrow, curved Cobb elevators, procedures can be performed through lateral portals without any additional skin incision. Following meticulous stepwise three-compartment elevation procedures based on the supraspinatus insertion anatomy, the supraspinatus muscle could be safely elevated from the fossa and sufficiently advanced laterally. The authors suggest that ASSA could be a useful procedure for management of challenging retracted rotator cuff tears by maximizing lateral excursions that could convert irreparable tears to reparable tears in select patients.

• Clinics in Shoulder and Elbow
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• 제23권1호
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• pp.41-47
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• 2020

Ulnar collateral ligament injuries have been increasingly common in overhead throwing athletes. Ulnar collateral ligament reconstruction is the current gold standard for managing ulnar collateral ligament insufficiency, and numerous reconstruction techniques have been described. Although good clinical outcomes have been reported regarding return to sports, there are still several technical issues including exposure, graft selection and fixation, and ulnar nerve management. This review article summarizes a variety of surgical techniques of ulnar collateral ligament reconstructions and compares clinical outcomes and biomechanics.

• 대한정형외과스포츠의학회지
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• 제2권2호
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• pp.136-141
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• 2003

슬관절의 후외측 불안정성은 많은 연구가 필요한 손상 중의 하나이다 치료에 있어서도 여러 술기들이 고안되어 왔지만 아직 까지 만족할 만한 치료법은 없는 상황이다. 이에 저자들은 동종 후경골건을 이 용하여 외측측부인대와 슬와건을 동시에 재건하는 새로운 술식을 소개하고자 한다.

• The Journal of Korean Physical Therapy
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• 제10권1호
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• pp.181-191
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• 1998

The age of specialization is upon physical therapy, as evidenced by the many special interest group. One of the special interest is manual therapy, which is the study of neurology, biomechanic, behavior science and pathology as well as the application of evaluative and treatment techniques of the neuromusculoskeletal system. Trend of manual therapy cover the whole medical in Europe. but America has two categories which is the neurologic manual therapy and the orthopedic manual therapy. The neurologic manual therapy was integrated with theory of PNF, Bobath technique, Vojta which is neurophysiologic approach concept. It is called motor control. A key aspect of the motor control requires a through knowledge of neurobiologic, biomechanic, and behavioral science. The orthopedic manual therapy runs to the evaluation and treatment of joints and their surrounding structures increase or decrease mobility and Fain control. In this article has to define and clarify the basic concepts of orthopedic manual therapy by comparing the general concepts, evaluation schemes, and treatment procedures of John McM Mennell, James Cyriax, Geoffrey Maitland, Freddy Kaltenborn and Ola Grimsby.

• 대한족부족관절학회지
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• 제4권2호
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• pp.87-92
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• 2000

The tendinous ends of neglected achilles tendon rupture tend to retract and separate with atrophy due to gastrosoleus muscle contracture, leaving a wide gap occupied with fibroadipose scar tissue. It is almost impossible to perform simple end-to-end anastomosis after the intervening scar tissue being excised. Therefore many surgical procedures have been proposed to reconstruct the large gap. We treated three such cases by V-Y advancement flap and double Krackow suture technique, and their postoperative strength of triceps surae were evaluated with Cybex isokinetic strength testing. All patients returned to preinjury activities with satisfaction, but the ankle plantar flexor power showed about 20-30% deficit.

• Clinics in Shoulder and Elbow
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• 제23권1호
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• pp.48-58
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• 2020

Although the prevalence of rotator cuff tears is dependent on the size, 11% to 94% of patients experience retear or healing failure after rotator cuff repair. Treatment of patients with failed rotator cuff repair ranges widely, from conservative treatment to arthroplasty. This review article attempts to summarize the most recent and relevant surgical options for failed rotator cuff repair patients, and the outcomes of each treatment, except arthroplasty.

• 대한족부족관절학회지
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• 제23권2호
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• pp.78-81
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• 2019

Hallux valgus with metatarsus adductus is difficult to treat and has a higher risk of recurrence after correction. Some treatments for hallux valgus with metatarsus adductus have been reported, but these are extensive procedures with a risk of complications associated with the shortening and malposition of the lesser metatarsals. The technique described here is easier to perform and has several advantages over the previously reported techniques.

• 대한족부족관절학회지
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• 제22권3호
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• pp.127-130
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• 2018

A 3rd degree burn on the heel including the Achilles tendon is vulnerable and requires active treatment to improve the functional outcomes. Previously, there have been a few treatments on severe burns, such as amputation, debridement or simple skin graft. The cooperative technique of an anterior lateral thigh flap with Achilles tendon reconstruction can be an innovative procedure that preserves the major arteries. The authors review a case and report the clinical outcome.

• Neurospine
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• 제15권4호
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• pp.376-382
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• 2018

Objective: The purpose of this study was to evaluate factors associated with inpatient admission following 2-level cervical disc arthroplasty (CDA). A secondary aim was to compare outcomes between those treated on an inpatient versus outpatient basis. Methods: Using data from the American College of Surgeons National Surgical Quality Improvement Program database, multivariate logistic regression analysis was used to assess the independent effect of each variable on inpatient or outpatient selection for surgery. Statistical significance was defined by p-values <0.05. The factors considered were age, sex, body mass index (BMI), smoking status, American Society of Anesthesiologists physical status classification, and comorbidities including hypertension, diabetes, history of dyspnea or chronic obstructive pulmonary disease, previous cardiac intervention or surgery, steroid usage, and history of bleeding. In addition, whether the operation was performed by an orthopedic or neurosurgical specialist was analyzed. Results: The number of 2-level CDA procedures increased from 6 cases reported in 2014 to 142 in 2016, although a statistically significant increase in the number of outpatient cases performed was not seen (p=0.2). The factors found to be significantly associated with inpatient status following surgery were BMI (p=0.019) and diabetes mellitus requiring insulin (p=0.043). There were no significant differences in complication and readmission rates between the inpatient and outpatient groups. Conclusion: Patients undergoing inpatient 2-level CDA had significantly higher rates of obesity and diabetes requiring insulin than did patients undergoing the same procedure in the outpatient setting. With no difference in complication or readmission rates, 2-level CDA may be considered safe in the outpatient setting in appropriately selected patients.

• Clinics in Shoulder and Elbow
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• 제26권4호
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• pp.380-389
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• 2023

Background: Total shoulder arthroplasty (TSA) with a nonspherical humeral head component and inlay glenoid is a successful bone-preserving treatment for glenohumeral arthritis. This study aimed to describe the 90-day complication profile of TSA with this prosthesis and compare major and minor complication and readmission rates between inpatient- and outpatient-procedure patients. Methods: A retrospective review was performed of a consecutive cohort of patients undergoing TSA with a nonspherical humeral head and inlay glenoid in the inpatient and outpatient settings by a single surgeon between 2017 and 2022. Age, sex, body mass index, American Society of Anesthesiologists (ASA) score, Charlson Comorbidity Index (CCI), and 90-day complication and readmission rates were compared between inpatient and outpatient groups. Results: One hundred eighteen TSAs in 111 patients were identified. Mean age was 64.9 years (range, 39-90) and 65% of patients were male. Ninety-four (80%) and 24 (20%) patients underwent outpatient and inpatient procedures, respectively. Four complications (3.4%) were recorded: axillary nerve stretch injury, isolated ipsilateral arm deep venous thrombosis (DVT), ipsilateral arm DVT with pulmonary embolism requiring readmission, and gastrointestinal bleed requiring readmission. There were no reoperations or other complications. Outpatients were younger with lower ASA and CCI scores than inpatients; however, there was no difference in complications (1/24 vs. 3/94, P=1.00) or readmissions (1/24 vs. 1/94, P=0.37) between these two groups. Conclusions: TSA with a nonspherical humeral head and inlay glenoid can be performed safely in both inpatient and outpatient settings. Rates of early complications and readmissions were low with no difference according to surgical setting. Level of evidence: IV.