• Title/Summary/Keyword: Posterior capsular

Search Result 35, Processing Time 0.026 seconds

MR Arthrography of the Labral-Capsular-Ligamentous Complex: Normal Variations and Pitfalls (관절와순낭인대(Labral-Capsular-Ligamentous) 복합체의 자기공명관절 조영술 : 정상변이 및 진단시 주의점)

  • Han Sung Ho;Yang Bo Kyu;Kim Chi Hong;Ahn Tae Won;Chu Wu Jun
    • The Academic Congress of Korean Shoulder and Elbow Society
    • /
    • 1997.05a
    • /
    • pp.164-166
    • /
    • 1997
  • MR arthrography is a useful modality for evaluating the labrocapsular ligamentous complex(LOLC) of the shoulder. This study was performed to describe normal anatomic variations and pitfalis in image interpretation related to evaluation of the LOLC. MR Arthrogram of 56 shoulders in 41 asymptomatic young, active volunteers were prospectively reviewed to evaluate the labral shapes. capsular insertions and images which may mimic the lesions of glenohumoral instability. The anterior and posterior parts of the labra. respectively. varied in shape: triangular$(72\%,\; 36\%)$. round $(13\%,\; 35\%)$. cleaved$(8\%,\; 1\%)$. notched$(2\%,\; 0\%)$. flat$(5\%,\; 24\%)$ and absent$(0\%,\; 4\%)$. The anterior and posterior capsular insertions. respectively. varied in sites: Mosely and Oevergaard type I$(82\%,\;62\%)$, type II$(13\%,\; 3\%)$ and type III $(5\%,\; 2\%)$. A number of pitfalls in image interpretation were discovered. Articular cartilage undercutting the labrum$(29\%)$ and middle glenohumoral ligament in proximity to anterior labrum $(5\%)$ simulated a labral tear. Joint fluid interposed in the central. superior portion of the sublabral sulci$(25\%)$ simulated a SLAP lesion. Synovial fold$(38\%)$ in axillary pouch resembled a loose body. Knowledge of normal variations and pitfalls in MR arthrogram image interpretation of labral capsular - ligamentous complex will help the orthopedist to accurately detect debilitating derangements associated with the glenohumeral instability.

  • PDF

The Effect of Knee Flexion and Posterior Septal Release on the Location of Popliteal Artery (무릎 굴곡 및 후방 관절낭 절제술이 슬와 동맥의 위치에 주는 영향)

  • Seo, Seung-Suk;Seo, Jin-Hyuk;Kim, Chang-Wan;Kwon, Yong-Wook
    • Journal of Korean Orthopaedic Sports Medicine
    • /
    • v.11 no.2
    • /
    • pp.69-74
    • /
    • 2012
  • Purpose: By confirm the change of popliteal arterial position when extension or flexion of the knee and estimate the change of popliteal arterial position after posterior capsular release, we tried to know the position can minimize injury of popliteal artery during arthroscopic surgery and usefulness of posterior capsular release. Materials and Methods: Total of two middle-aged man and woman, fresh frozen cadavers as systemic, all four cases of the knee were included in this study. After the knee was flexed to 0 degrees, 30 degrees, 60 degrees, 90 degrees angle, we estimated distance from posterior tibial cortex to popliteal artery at articular surface, the distal 1 cm and 2 cm from articular surface. We performed posterior capsular release by arthroscopy, and estimated distance between posterior tibial cortex and popliteal artery in the same way. Results: Mean distance between popliteal artery and posterior tibial cortex was 6.3 mm (4.5~7), 4.6 mm (3.6~6), 4.9 mm (3.9~5.8) when knee flexion to 0 degrees at articular surface, distal 1 cm and 2 cm from articular surface each. When knee flexion to 30 degrees, it was 7.4 mm (5.2~9), 4.9 mm (3.6~7.2), 5.3 mm (3.8~6.6). When knee flexion to 60 degrees, it was 8.7 mm (5.4~11), 5.2 mm (4.9~7.3), 6.2 mm (5.4~9.6). When knee flexion to 90 degrees, it was 9.8 mm (5.8~12.1), 5.5 mm (5.1~7.4), 6.5 mm (5.4~10.7). After posterior capsule release, the distance was 6.5 mm (5.5~7.5), 5.8 mm (3.9~7.2), 5.2 mm (3.8~7.0) when knee flexion to 0 degrees, 7.7 mm (5.5~9,1), 7.1 mm (4.6~7.6), 5.5 mm (4.1~6.9) when knee flexion to 30 degrees, 8.9 mm (5.7~11.2), 8.5 mm (5.5~9.2), 6.4 mm (5.3~10.1) when knee flexion to 60 degrees and 10.2 mm (6.3~13.6), 9.5 mm (6.5~11), 6.6 mm (5.9~9.8) when knee flexion to 90 degrees. Conclusion: As knee joint is flexed, the distance from posterial tibial cortex to popliteal artery are increased beween knee joint articular surface and distal 2 cm from knee joint. So popliteal artery injury will be reduced at knee joint surgery. Posterior capsular release could also reduce popliteal artery injury by increasing distance between posterior tibial cortex and popliteal artery.

  • PDF

Arthroscopic Posterior Capsular Shaft for Traumatic Recurrent Unidirectional Posterior Subluxation of the Shoulder (외상으로 인한 재발성 단방향 견관절 후방 아탈구의 관절경을 이용한 후방낭 이동술)

  • Kim, Seung-Ho;Ha, Kwon-Ick;Yoo, Jae-Chul;Lee, Yong-Seuk;Lee, Hui-Dong
    • Clinics in Shoulder and Elbow
    • /
    • v.6 no.1
    • /
    • pp.55-66
    • /
    • 2003
  • Background: The purpose of this study was to evaluated results of arthroscopic treatment of the traumatic recurrent unidirectional posterior subluxation. Materials and Methods: We treated twenty-seven patients who had traumatic recurrent unidirectional posterior subluxation of the shoulder by arthroscopic labral repair and posterior capsular shift and prospectively evaluated for a mean of thirty-nine months (range,24 to 85 months). Patients who had posteroinferior instability, multidirectional instability, atraumatic onset, or revision cases were excluded. There were twenty-five male and two female patients with the mean age of twenty-one years (range, 14 to 33 years). All patients were involved in sports activity. All had a significant traumatic event prior to the onset of the instability. Stability, motion, three objective measurement (UCLA, ASES, and Rowe scores) and two subjective measurements (pain and function visual analogue scale) were evaluated. Results: The most common finding in magnetic resonance image-arthrogram was separation of the posteroinferior labrum without displacement in 9 patients, In arthroscopic examination, all patients had one or more lesions in the posterior inferior labrum and capsule. The most common finding was incomplete stripping of the posterior inferior labrum (18 patients). The posteroinferior capsule subjectively appeared to be stretched in twenty-two patients. At follow-up, all patients had improved shoulder function and scores(p < 0.01). All patients had stable shoulder by subjectivel and objectivel measurements, except one patient who had recurrent subluxation. All but one patient with postoperative recurrence were able to return to their prior sports activity with little or no limitation. Twenty-four patients were graded as having more than 90% of shoulder function. Their were twenty-one excellent, five good, and one fair UCLA. scores. Pain sore improved from 4.5 to 0.2 point(p : 0.0001). Mean loss internal rotation was one vertebral level. None had operative complications. Conclusion: In conclusion, treatment outcomes of the traumatic unidirectional recurrent posterior subluxation are consistently reliable with respect to the stability, pain relief, and functional restoration by the arthroscopic posterior capsular shift procedure.

Arthroscopic Treatment of Coronoid Impingement in Stiff Elbow

  • Lee Yong Geol
    • The Academic Congress of Korean Shoulder and Elbow Society
    • /
    • 1999.03a
    • /
    • pp.38-40
    • /
    • 1999
  • $\cdot$ Arthroscopic management is the effective method with acceptable results for coronoid impingement of stiff elbow contributing to the functional improvement and pain relief. $\cdot$ The functional improvement and pain relief seem to be affected by the severity of a degenerative change of the elbow joint. $\cdot$ Excision of coronoid process is required in a marked limitation of further flexion in addition to deeping of the coronoid fossa and anterior capsular release. $\cdot$ Excision of olecranon tip or posterior capsular release are effective method in severe flexion contracture.

  • PDF

Clinical Characteristics of Papillary Thyroid Microcarcinoma Involving Posterior Thyroidal Capsule (갑상선 후방 피막을 침범하는 갑상선미세유두암의 임상양상에 대한 고찰)

  • Jang, Seong Uk;Oh, Jung Ho;Kim, Seo Bin;Kim, Sung Won;Lee, Hyoung Shin;Noh, Woong Jae;Lee, Kang Dae
    • Korean Journal of Head & Neck Oncology
    • /
    • v.31 no.2
    • /
    • pp.6-10
    • /
    • 2015
  • Background and Objective : Papillary thyroid microcarcinoma(PTMC) is known as slow growing cancer with good prognosis. However, extrathyroidal extension may increase the risk of cervical lymph node metastasis and local invasion to surrounding structures. The aim of this study was to assess the characteristic features of the tumor invading the posterior thyroid capsule. Material and Methods : We made a retrospective review of 123 PTMC patients with thyroid capsule invasion, pathologically staged as T3 or T4. 74 patients (60.2%) had invasion to posterior thyroid capsule (group A) while 49 patients (39.8%) had invasion to-anterior thyroid capsule or anterior wall of trachea (group B). We assessed the clinicopathologic factors of the patients according to the location of capsular invasion of PTMC. Results : There was no difference regarding age, gender, T and N classification and incidence of lymph node metastasis between two groups. Local invasion rate to recurrent laryngeal nerve was 6.8% in patients with posterior thyroid capsule invasion, while the incidence was zero in those with capsular invasion to other locations Conclusion : Increased risk of local invasion to the recurrent laryngeal nerve should be considered in patients with PTMC presenting invasion of the posterior capsule.

  • PDF

What Should We Treat For Recurrent Dislocation? (재발성 탈구에서 무엇을 치료할 것인가?)

  • Tae Suk-Kee
    • Clinics in Shoulder and Elbow
    • /
    • v.7 no.1
    • /
    • pp.1-4
    • /
    • 2004
  • As the multidirection and posterior instabilities of the shoulder are not only uncommon but responds well to conservative treatment, the shoulder instabilities which requires surgical treatment are traumatic anterior type in most cases, Although various surgical procedures had been used in the past, Bankart procedure is the standard surgical method as a primary procedure in traumatic anterior instability, Nevertheless there has been changes in the techniques of Bankart procedure in order to minimize decrease of external rotation and effectively address capsular laxilty, Capsular shift might be needed if there remains excessive capsular laxity of the inferior capsule after repair of the Bankart lesion, Large bony Bankart lesion should be fixed if possible and severe glenoid rim erosion requires extracapsular bone block after repair of the capsule. Although a few surgical procedures are described for the management of Hill-Sachs lesion in special circumstances, Hill-Sachs lesion does not usually need to be addressed.

Phacoemulsification for Cataract Extraction in Dogs: 85 eyes (1999-2001) (개의 백내장 적출을 위한 수정체유화흡인술:85 안 (1999-2001))

  • 김완희;권오경
    • Journal of Veterinary Clinics
    • /
    • v.19 no.4
    • /
    • pp.411-414
    • /
    • 2002
  • Eighty five canine eyes performed phacoemulsification for cataract extraction between January 1999 and December 2001 were reviewed. Mean age was 7.26 years old and main breed was poodle (37 dogs). Mature cataract was 51.76%, immature cataract 27.05% and hypermature 21.18%. Improvement of vision was detected in 75 (88.24%) of 85 eyes at 4 weeks after surgery. Postoperative complications were posterior capsular opacification(6), partial posterior synechia(5), glaucoma(3) and uveitis(2). Reasons for failure of visual improvement among the patients performed phacoemulsification were mainly related to development of postoperative anterior uveitis, secondary glaucoma and progressive retinal degeneration.