• Title/Summary/Keyword: Orthopedics

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Ultrasonographic Findings of Normal Hip Joint and Painful Hip due to Soft Tissue Problem (고관절 초음파의 정상 소견 및 고관절 주위 질환의 초음파 소견)

  • Nam, Woo-Dong;Nam, Shin Woo;Han, Kye Young
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.1
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    • pp.38-46
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    • 2010
  • The lesions around hip joint including bone, joint and soft tissue can cause the pain. For diagnosis of these lesions, physical examination and simple X-ray were accomplished primarily. Some special cases, CT or MRI was a useful tool. However ultrasonography could provide non-invasive and dynamic images for the lesions of tendon and bursa, and it could be a useful tool for follow up after hip surgery. Due to the deep location of hip joint, ultrasonography is not easy for physician to examine and its application was impossible in some obese patients. This article deals with the normal and pathologic ultrasonographic findings of the hip joint and various applications using ultrasonography.

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Anatomy, Biomechanics and Physical Examination of Foot and Ankle (족부 및 족관절의 해부학, 생역학 및 신체 검사)

  • Hur, Chang-Yong;Kim, Hak Jun
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.1
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    • pp.32-37
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    • 2010
  • Ultrasonographic diagnosis and treatment in Orthopaedic fields had been widely used. Sonographic diagnosis and treatment of foot and ankle is convenient because of anatomical characteristics. The knowledge of the anatomy and biomechanics in foot and ankle area can help to diagnose and treat the disease around foot and ankle. 28 bone and many tendons, ligaments and muscles are consist of ankle and foot joint and the coordinative relation among these structures can allow the dual function, weight bearing and locomotion of ankle and foot during gait cycle. Foot and ankle have small room for many structures, so systemically physical examination is essential for diagnosis. Accurate understanding of foot and ankle anatomy and biomechanics could be helpful to using ultrasonograph.

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Can Right-Handed Surgeons Insert Upper Thoracic Pedicle Screws in much Comfortable Position? Right-Handedness Problem on the Left Side

  • Akyoldas, Goktug;Senturk, Salim;Yaman, Onur;Ozdemir, Nail;Acaroglu, Emre
    • Journal of Korean Neurosurgical Society
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    • v.61 no.5
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    • pp.568-573
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    • 2018
  • Objective : Thoracic pedicles have special and specific properties. In particular, upper thoracic pedicles are positioned in craniocaudal plane. Therefore, manipulation of thoracic pedicle screws on the left side is difficult for right-handed surgeons. We recommend a new position to insert thoracic pedicle screw that will be much comfortable for spine surgeons. Methods : We retrospectively reviewed 33 patients who underwent upper thoracic pedicle screw instrumentation. In 15 patients, a total of 110 thoracic pedicle screws were inserted to the upper thoracic spine (T1-6) with classical position (anesthesiologist and monitor were placed near to patient's head. Surgeons were standing classically near to patient's body while patients were lying in prone position). In 18 patients, a total of 88 thoracic pedicle screws were inserted to the upper thoracic spine with the new standing position-surgeons stand by the head of the patient and the anesthesia monitor laterally and under patient's belt level. All the operations performed by the same senior spine surgeons with the help of C-arm. Postoperative computed tomography scans were obtained to assess the screw placement. The screw malposition and pedicle wall violations were divided and evaluated separately. Cortical penetration were measured and graded at either : 1-2 mm penetration, 2-4 mm penetration and >4 mm penetration. Results : Total 198 screws were inserted with two different standing positions. Of 198 screws 110 were in the classical positioning group and 88 were in the new positioning group. Incorrect screw placement was found in 33 screws (16.6%). The difference between total screw malposition by both standing positions were found to be statistically significant (p=0.011). The difference between total pedicle wall violations by both standing positions were found to be statistically significant (p=0.003). Conclusion : Right-handedness is a problem during the upper thoracic pedicle screw placement on the left side. Changing the surgeon's position standing near to patient's head could provide a much comfortable position to orient the craniocaudal plane of the thoracic pedicles.

Biomechanical Validation about Dumbbell Curl Exercise Effects of Virtual Environment (가상환경 변화에 따른 덤벨 컬 운동효과에 관한 운동역학적 검증)

  • Hong, Ah Reum;Kim, Jai Jung;So, Jae Moo
    • Korean Journal of Applied Biomechanics
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    • v.30 no.1
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    • pp.111-119
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    • 2020
  • Objective: The purpose of this study is to apply exercise learning effect to various subjects through training effect and information accumulation based on verification of the effect on dumbbell curl exercises applied with virtual reality. Method: To analyze the effect on the dumbbell curl exercise in the virtual environment, a total of 20 persons with 10 males and 10 females who does not have orthopedics diseases were selected. The dumbbell weight of the subjects was set to a weight of 70% strength of 1RM. At this time, the virtual environment situation was set to four types; presence/absence of virtual environment, preferred colors, and unfavorable colors to perform dumbbell curl exercise. The anaysis of muscle activity was conducted by adhering four surface electrodes (Biceps Brachii, Triceps Brachii, Brachioradialis Muscle, Extensor Carpi Radialis Longus Muscle) on the right upper limbs. Independent sample t-test using SPSS (24.0) program was carried out to analyze average values and standard deviations for each variable depending on the presence/absence of virtual environments and changes in color (preferred colors, unfavorable colors) and the level of significance was set to a=.05. Results: In the eccentric contraction, males showed high muscle activity in the Biceps Brachii under virtual reality. On the other hand, females had high muscle activity in the Biceps Brachii in the absence of virtual reality. Also, in case of a change of colors in the virtual environment, females had the high muscle activity in the unfavorable color in the eccentric contraction. Conclusion: During the dumbbell curl exercise, results of different exercises present depending on gender. When males put VR on and performs a basic dumbbell curl exercise, the effect of Biceps presents Brachii for them while exercising in unfavorable colors. However, since it is the basic research data of muscle exercise using virtual reality, it is necessary to verify whether or not it is effective for myopachynsis through long-term training rather than unity.

Arthroscopic Findings of the Canine Stifle Joint (정상견 무릎의 관절경 검사소견)

  • 정순욱;정월순
    • Journal of Veterinary Clinics
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    • v.16 no.2
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    • pp.300-308
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    • 1999
  • Arthroscopy is a valuable diagnostic and operative tool in equine and human orthopedics. The arthroscope is a difficult instrument to use and requires patience, practice, and persistence in order to obtain good results. This technique was found to be less traumatic than arthrotomy, invasiveness, rapid recovery and the feasibility of surgically correcting many arthropathies. The use of the arthroscope in the dog provides a new dimension in the study and diagnosis of joint derangements. The purpose of this report is to introduce the use of the arthroscope in the dog-more specifically, in the stifle of the dog. A diameter 2.7 mm fore-oblique viewing arthroscope, cold light source, video and video printer are used. With the fore-oblique viewing type it is possible to view directly as well as slightly to the side and the range of viewing can be increased by rotating the arthroscope around the object The scope is connected with a cold light source by means of a fiber-optic light guide. The stifle joint was flexed to 20~30$^{\circ}$. The joint were lavaged with lactated Ringer's solution during arthroscopic examination. Arthroscopy of the stifle was performed prior to arthrotomy in 1 dead dog and 4 healthy dogs, and other 3 dogs was performed only arthroscopic examination. In this study only the conventional approaches were used and in most cases it was possible to view all the intra-articular structures via the lateral infrapatellar approach. In the stifle joint, endoscopic observation was performed to find lateral femoral condyle, patella, medial femoral condyle, trochlear groove, tibia, fat, cranial cruciate ligament, caudal cruciate ligament lateral meniscus, tendon of long digital extensor muscle, medial meniscus, and medial collateral ligament Post-arthroscopic examination, the lameness had disappeared within 12~24 hours. Pain and swelling in the stifle joint had disappeared within 24~36 hours. Post-arthroscopic secondary infection was never encountered in the dogs. In conclusion, arthroscopic insertion technique in canine stifle joint using a diameter 2.7 mm 30$^{\circ}$ arthroscope was established and arthroscopical views of all anatomical structures in the normal stilfe joint were obtained through lateral infrapatellar portal.

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Acupotomy for Scapulohumeral Periarthritis

  • Guo, Chang Qing;Ma, Shi Ning;Fu, Xin Yi;Wang, Quan Gui;Lee, Mira
    • Journal of Acupuncture Research
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    • v.37 no.4
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    • pp.254-258
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    • 2020
  • Background: Scapulohumeral periarthritis causes pain and stiffness, and limits movement but it is a treatable condition. This was a clinical study of acupotomy treatment for scapulohumeral periarthritis. Methods: There were 80 patients randomly assigned to the traditional Chinese Medicine group (acupotomy) and the Western medicine group (naproxen), with 40 cases in each group. All patients had adjunct physiotherapy exercises for 14 days. Patients received acupotomy treatment 3 times for 14 days (Day 0, 7 and 14) or naproxen (0.22 g capsule; a non-steroidal anti-inflammatory drug) 3 times a day, for 14 days. The visual analogue scale (VAS) scores, range of motion (ROM) values, and the Melle scale, together with the therapeutic standard of diseases and syndromes in traditional Chinese Medicine were used for diagnosis and evaluation. Results: There were significant differences in the VAS scores, ROM, Melle scores, cure rate and total effective rate in the group which took naproxen and the acupotomy group, before and after treatment (p < 0.01). There were significant differences in the changes in VAS, ROM and Melle scores between the 2 groups (p < 0.01), and the acupotomy group was better than the naproxen group. Conclusion: Traditional Chinese Medicine and Western medicine can improve functional activity and reduce the level of pain experienced by patients suffering from scapulohumeral periarthritis. However, improvement of functional activity of the shoulder joint following acupotomy treatment was more obvious than the use of a non-steroidal anti-inflammatory drug, and the cure rate, and total effective rate of acupotomy was better.

Validity of palatal superimposition of 3-dimensional digital models in cases treated with rapid maxillary expansion and maxillary protraction headgear

  • Choi, Jin-Il;Cha, Bong-Kuen;Jost-Brinkmann, Paul-Georg;Choi, Dong-Soon;Jang, In-San
    • The korean journal of orthodontics
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    • v.42 no.5
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    • pp.235-241
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    • 2012
  • Objective: The purpose of this study was to evaluate the validity of the 3-dimensional (3D) superimposition method of digital models in patients who received treatment with rapid maxillary expansion (RME) and maxillary protraction headgear. Methods: The material consisted of pre- and post-treatment maxillary dental casts and lateral cephalograms of 30 patients, who underwent RME and maxillary protraction headgear treatment. Digital models were superimposed using the palate as a reference area. The movement of the maxillary central incisor and the first molar was measured on superimposed cephalograms and 3D digital models. To determine whether any difference existed between the 2 measuring techniques, intra-class correlation (ICC) and Bland-Altman plots were analyzed. Results: The measurements on the 3D digital models and cephalograms showed a very high correlation in the antero-posterior direction (ICC, 0.956 for central incisor and 0.941 for first molar) and a moderate correlation in the vertical direction (ICC, 0.748 for central incisor and 0.717 for first molar). Conclusions: The 3D model superimposition method using the palate as a reference area is as clinically reliable for assessing antero-posterior tooth movement as cephalometric superimposition, even in cases treated with orthopedic appliances, such as RME and maxillary protraction headgear.

A case of severe mandibular retrognathism with bilateral condylar deformities treated with Le Fort I osteotomy and two advancement genioplasty procedures

  • Nakamura, Masahiro;Yanagita, Takeshi;Matsumura, Tatsushi;Yamashiro, Takashi;Iida, Seiji;Kamioka, Hiroshi
    • The korean journal of orthodontics
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    • v.46 no.6
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    • pp.395-408
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    • 2016
  • We report a case involving a young female patient with severe mandibular retrognathism accompanied by mandibular condylar deformity that was effectively treated with Le Fort I osteotomy and two genioplasty procedures. At 9 years and 9 months of age, she was diagnosed with Angle Class III malocclusion, a skeletal Class II jaw relationship, an anterior crossbite, congenital absence of some teeth, and a left-sided cleft lip and palate. Although the anterior crossbite and narrow maxillary arch were corrected by interceptive orthodontic treatment, severe mandibular hypogrowth resulted in unexpectedly severe mandibular retrognathism after growth completion. Moreover, bilateral condylar deformities were observed, and we suspected progressive condylar resorption (PCR). There was a high risk of further condylar resorption with mandibular advancement surgery; therefore, Le Fort I osteotomy with two genioplasty procedures was performed to achieve counterclockwise rotation of the mandible and avoid ingravescence of the condylar deformities. The total duration of active treatment was 42 months. The maxilla was impacted by 7.0 mm and 5.0 mm in the incisor and molar regions, respectively, while the pogonion was advanced by 18.0 mm. This significantly resolved both skeletal disharmony and malocclusion. Furthermore, the hyoid bone was advanced, the pharyngeal airway space was increased, and the morphology of the mandibular condyle was maintained. At the 30-month follow-up examination, the patient exhibited a satisfactory facial profile. The findings from our case suggest that severe mandibular retrognathism with condylar deformities can be effectively treated without surgical mandibular advancement, thus decreasing the risk of PCR.

The Effect of Sling Lumbar Stabilization Exercise to Muscle Body Type and Subjective Pain Degree of Men Who Have Sacroiliac Joint Syndrome (8주간의 슬링을 이용한 요부안정화 운동이 천장관절 증후군 남성의 근체형 및 주관적 통증정도에 미치는 효과)

  • Baek, Soon-Gi
    • Journal of Digital Convergence
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    • v.12 no.12
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    • pp.651-658
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    • 2014
  • The purpose of this study is to see how the sling lumbar stabilization exercise affects muscle body type and subjective pain degree of 17 middle-age men who are diagnosed with sacroiliac joint syndrome and investigate the effectiveness. The subjects of this study are patients who have been diagnosed with sacroiliac joint syndrome through tests like X-ray in S Orthopedics in C City and have had chronic lumbar pain for more than 6 months and the before and after results about subjective pain degree through three dimension Moire Muscle Body Type Tester and subjective pain degree through VAS Pain Awareness after sling lumbar stabilization exercise 3 times a week, 30 minutes a time, total 24 times for 8 weeks have revealed the following: The change of muscle body type has been comprehensively improved in the statistics before and after the exercise and the subjective pain degree has also comprehensively decreased in the statistics. Therefore, sling lumbar stabilization exercise is proved to give positive affect to muscle body type and pain improvement of the patients with sacroiliac joint syndrome.

Novel analysis model for implant osseointegration using ectopic bone formation via the recombinant human bone morphogenetic protein-2/macroporous biphasic calcium phosphate block system in rats: a proof-of-concept study

  • Park, Jung-Chul;Lee, Jong-Bin;Daculsi, Guy;Oh, Sang-Yeop;Cho, Kyoo-Sung;Im, Gun-Il;Kim, Byung-Soo;Kim, Chang-Sung
    • Journal of Periodontal and Implant Science
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    • v.42 no.4
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    • pp.136-143
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    • 2012
  • Purpose: The osseointegration around titanium mini-implants installed in macroporous biphasic calcium phosphate (MBCP) blocks was evaluated after incubation with recombinant human bone morphogenetic protein-2 (rhBMP-2) in an ectopic subcutaneous rat model. Methods: Mini-implants (${\varphi}1.8{\times}12$ mm) were installed in MBCP blocks (bMBCPs, $4{\times}5{\times}15$ mm) loaded with rhBMP-2 at 0.1 mg/mL, and then implanted for 8 weeks into subcutaneous pockets of male Sprague-Dawley rats (n=10). A histomorphometric analysis was performed, and the bone-to-implant contact (BIC) and bone density were evaluated. Results: Significant osteoinductive activity was induced in the rhBMP-2/bMBCP group. The percentage of BIC was $41.23{\pm}4.13%$ (mean${\pm}$standard deviation), while bone density was $33.47{\pm}5.73%$. In contrast, no bone formation was observed in the bMBCP only group. Conclusions: This model represents a more standardized tool for analyzing osseointegration and bone healing along the implant surface and in bMBCPs that excludes various healing factors derived from selected animals and defect models.