• Title/Summary/Keyword: Posterior dislocation

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Effect of Temporary Anterior Positioning Splint Using Putty Impression Material on Acute Closed Lock (급성 과두 걸림의 치료에서 퍼티 고무 인상재로 제작한 임시 전방위치장치의 적용)

  • Song, Ji-Hee;Kim, Ji-Hyun;Kwon, Jeong-Seung;Ahn, Hyung-Joon
    • Journal of Oral Medicine and Pain
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    • v.37 no.4
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    • pp.221-225
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    • 2012
  • Disc dislocation without reduction, as known as closed lock, is a clinical condition in which the disc is dislocated from the condyle and does not return to normal position during condylar movement When the condition of disc dislocation without reduction is acute, the initial therapy should include an attempt to reduce or recapture the disc by manual manipulation. When patients report a history of being locked for 1 week or less, manual manipulation is usually successful. In patients with a longer history, success rate tends to decrease rapidly. If the disc has been successfully recaptured, placing an anterior positioning appliance is recommended to prevent clenching on the posterior teeth, which would likely redislocated the disc. But it is hard to make an appliance immediately in the clinic because it takes too much time. And making an appliance using self-curing acrylic resin is not very popular because of its discomfort by odor and working time. Also, if the patient has resin allergy or is under orthodontic treatment, or if it is impossible to control behavior of the patient, it has been restricted to make an appliance immediately. Therefore, to supplement this disadvantages, we tried to confirm about successful short term use of temporary anterior positioning splint made by using putty impression material after manual manipulation in this study.

Cephalometric Characteristics of the Patients with Developed Anterior Open Bite Following Anterior Disc Dislocation without Reductions (비정복성 관절원판 전위와 연관되어 발생된 전치부 개교합 환자의 측방 두부방사선 계측)

  • Hur, Yun-Kyung;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.31 no.3
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    • pp.255-263
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    • 2006
  • Objectives: This article reported three patients developed anterior open bite seemed to be related to TMJ anterior disc dislocation without reduction(ADD WO R), but no evidence of condylar destructive or collapse and analyzed the craniofacial skeletal structure by means of cephalometric analysis. Results: All patients suddenly developed a centric relation/centric occlusion discrepancy, an increased overjet and an anterior open bite following ADD WO R. All patients had Angle's Class I occlusion and shallow bite, but they had skeletally Class III and Class II pattern and all were vertically significant hyperdivergent type. Conclusions: These 3 patients had characteristics of common facial morphology including:(1)Angle classification Class I and shallow bite,(2)high mandibular plane angle,(3)high gonial angle. Developed anterior open bite resulted from clockwise rotation of the mandible related TMJ ADD WO R, rather than a result from the eruption of posterior teeth. We hypothesize rotation may relate to attached direction of masticatory muscle.

Analysis of the Calcaneocuboid Joint Involvement in Intraarticular Calcaneal Fractures (관절내 종골 골절에서 종입방 관절 침범 분석)

  • Shin, Won-Ju;Yang, Sang-Hoon;Park, Hong-Ki
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.1
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    • pp.42-47
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    • 2006
  • Purpose: This study was performed to analyze the characteristics of calcaneocuboid joint involvement in intraarticular calcaneal fractures. Materials and Methods: Total number of 92 patients (111 cases) who underwent operation for intraarticular calcaneal fractures between Jan. 2000 and Oct. 2005 were included in this study. The preoperative computed tomographs of the subjects were retrospectively reviewed to analyze calcaneocuboid joint involvement. Results: It was revealed that 63 cases (56.8%) involved calcaneocuboid joint; 29cases (46.0%) showed type 1 (undisplaced or minimally displaced type, articular gap ${\le}1\;mm$), 16 cases (25.4%) exhibited type 2 (moderately displaced type, articular gap ${\ge}2\;mm$), 7 cases (11.1%) were included in type 3 (comminuted type) and 11 cases (17.5%) belonged to type 4 (fracture and dislocation). 48 out of 63 cases belonged to Sanders classification II and III that involved calcaneocuboid joint and included 25 cases (52.1%) of type 1 and 14 cases (29.2%) of type 2. Among 15 out of 63 cases included in Sanders classification IV, 4 (26.7%) showed type 1 and 6 (40.0%) belonged to type 4. According to our results, Sanders classification allowed to predict pattern of the involvement of calcaneocuboid joint (P<0.05). However, there was no statistically significant relationship between degree of posterior facet joint injuries and calcaneocuboid joint involvement (P>0.05). Conclusion: Calcaneocuboid joint involvement in intraarticular calcaneal fractures was common and more than half showed severe injuries. We concluded that further studies on the involvement of calcaneocuboid joint should be performed prior to surgical treatment of intraarticular calcaneal fractures.

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A Study of the Hinge Axis Point (Hinge Axis Point에 관한 연구)

  • Jung, Kum-Tae
    • The Journal of Korean Academy of Prosthodontics
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    • v.22 no.1
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    • pp.72-78
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    • 1984
  • The notion that the axis of the shaft of the articulator must coincide the patient's mandibular transverse axis tells us the importance of locating the axis precisely. When using kinematic axis to transfer a cast to an articulator, the anatomic asymmetry of the contralateral points will result in certain distortion when the axis transferred to an articulator where the mechanical axis produces symmetry. In this study, after locating the true hinge axis point with Denar hinge axis locator, the discrepancies between true hinge axis point and arbitrary hinge axis point that was 13mm anterior from the posterior margin of center of trangus to the outer canthus of eye were measured. And the discrepancies between left and right true hinge axis point in the superoinferior and anteroposterior directions were measured. For this study, 20 dental students who have no missing teeth and no difficulties of mandibular movement were selected. Upper and lower cast of subjects were mounted on Denar Mark II articulator uisng Denar Slidematic face-bow and centric relation record for the measurement of discrepancies between left and right true hinge axis points. The results obtained as follows. 1. The mean distance from the arbitrary hinge axis point to the true hinge axis point was as follows. Right: horizontal distance; 1.99mm, vertical distance; 2.12mm, linear distance; 3.36 mm. Left: horizontal distance; 1.39mm, vertical distance; 2.06mm, linear distance; 2.09mm. Total: horizontal distance; 1.69mm, vertical distance; 2.09mm linear distance; 3.06 mm. 2. The 87.5% of true hinge axis points were within 5mm of the arbitrary hinge axis point. 3. The mean discrepancies between the right and left hinge axis point were 2.92mm in superoinferior direction and 4.74mm in anteroposterior direction. 4. When transferring the axis to the articulator, anatomic asymmetry between right: and left axis point produces in dislocation of cast on the articulator, and undesirable shift in esthetic tooth position will be resulted.

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The Transmanubrial Approach for Cervicothoracic Junction Lesions : Feasibility, Limitations, and Advantages

  • Park, Jong-Hyun;Im, Soo Bin;Jeong, Je Hoon;Hwang, Sun Chul;Shin, Dong-Seung;Kim, Bum-Tae
    • Journal of Korean Neurosurgical Society
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    • v.58 no.3
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    • pp.236-241
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    • 2015
  • Objective : We report on the technical feasibility and limitations of the transmanubrial approach for cervicothoracic junction (CTJ) lesions and emphasize the advantage of bisecting the upper part of the manubrium in an inverted Y-shape. Methods : Thirteen patients who underwent the fourteen transmanubrial approach for various CTJ lesions were enrolled during 2005-2014. For the evaluation of the accessibility for the CTJ lesion, we analyzed the two parallel line defined as a straight line parallel to the inferior and superior plateau of the upper and lower healthy vertebrae, the angle of the two parallel lines and the distance from the sternal notch to lines at the sternum on preoperative magnetic resonance images. Surgical limitations and perspectives, as well as postoperative clinical outcomes were evaluated retrospectively. Results : The CTJ lesions were six metastases, three primary bone tumors, two herniated discs, and one each of a traumatic dislocation with syrinx formation and tuberculous spondylitis and ossification of the posterior longitudinal ligament. If two parallel lines pass below the sternal notch, the manubriotomy should be inevitably performed. The mean preoperative Visual analogue scale score was 8 (range, 5-10), which improved to 4 (range, 0-6) postoperatively. Seven cases showed an increase in Frankel score postoperatively. Conclusion : The spatial relationship between the sternal notch and the two parallel lines to the lesion was rational to determine the feasibility of manubriotomy. The transmanubrial approach for CTJ lesions can achieve favorable clinical outcomes by providing direct decompression of lesion and effective reconstruction.

The Diagnosis of Rheumatologic and Degenerative Arthritis by X-ray Sacroiliac Joint Projection (X-ray 엉치엉덩관절 촬영법을 통한 류마티스 및 퇴행성관절염 진단)

  • Lee, Jun-Haeng
    • Journal of the Korean Society of Radiology
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    • v.12 no.3
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    • pp.397-402
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    • 2018
  • The study best image for diagnosis of fracture, dislocation and unilateral degenerative arthritis of the Sacroiliac joint, this study was performed to obtain the best image of the joint space of the hip joint by giving angle change to the pelvis phantom and the x-ray tube. I received evaluation. The results of the Receiver Operating Characteristic that in the case of simple photographs for the detection of joint arthritis and degenerative arthritis in the prone position, the photograph taken in the prone position raises the buttocks of the opposite side of the test by $25^{\circ}{\sim}30^{\circ}$ and the x-ray tube is perpendicular to the sagittal plane passing 2.5 cm inward from the thorny vertebra In the lying position, lift the Sacroiliac joint of the test side by $25^{\circ}{\sim}30^{\circ}$, and take a $5^{\circ}$ angle of the x-ray tube angle toward the foot toward the center of the upper bruch spine from it will be helpful to diagnose arthritis. the center of the upper bruch spine to the side of the ankle joints in the transverse direction And posterior direction, it will be helpful to diagnose arthritis.

Treatment of extensive comminuted mandibular fracture between both mandibular angles with bilateral condylar fractures using a reconstruction plate: a case report

  • Lee, Kwonwoo;Yoon, Kyuho;Park, Kwan-Soo;Cheong, Jeongkwon;Shin, Jaemyung;Bae, Jungho;Ko, Inchan;Park, Hyungkoo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.40 no.3
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    • pp.135-139
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    • 2014
  • This following case report describes the open reduction, internal fixation and the reconstruction of an extensive comminuted mandibular fracture with bilateral condylar fractures in a 19-year-old male patient with an intellectual disability and autistic disorder. He suffered fall trauma, resulting in shattered bony fragments of the alveolus and mandibular body between both mandibular rami, the fracture of both condyles and the avulsion or dislocation of every posterior tooth of the mandible. The patient underwent open reduction and internal fixation between both mandibular rami using a reconstruction plate, open reduction and internal fixation of the shattered fragments using miniplates and screws, and the closed reduction of the bilateral condylar fractures.

An Analysis of Stress Pattern in the Coracoclavicular Ligaments with Scapular Movements: A Cadaveric Study Using Finite Element Model

  • Kim, Yoon Sang;Kim, In-Sung;Yoo, Yon-Sik;Jang, Seong-Wook;Yang, Cheol-Jung
    • Clinics in Shoulder and Elbow
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    • v.18 no.3
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    • pp.152-158
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    • 2015
  • Background: Acromioclavicular (AC) stability is maintained through a complex combination of soft-tissue restraints that include coracoclavicular (CC), AC ligament and overlying muscles. Among these structures, the role of the CC ligament has continued to be studied because of its importance on shoulder kinematics, especially after AC injury. This study was designed to determine the geometric change of conoid and trapezoid ligaments and resulting stresses on these ligaments according to various scapular motions. Methods: The scapuloclavicular (SC) complex was isolated from a fresh-frozen cadaver by removing all soft tissues except the AC and CC ligaments. The anatomically aligned SC complex was then scanned with a high-resolution computed tomography scanner into 0.6- mm slices. The Finite element model of the SC complex was obtained and used for calculating the stress on different parts of the CC ligaments with simulated movements of the scapula. Results: Average stress on the conoid ligament during anterior tilt, internal rotation, and scapular protraction was higher, whereas the stress on the trapezoid ligament was more prominent during posterior tilt, external rotation, and retraction. Conclusions: We conclude that CC ligament plays an integral role in regulating horizontal SC motion as well as complex motions indicated by increased stress over the ligament with an incremental scapular position change. The conoid ligament is the key structure restraining scapular protraction that might occur in high-grade AC dislocation. Hence in CC ligament reconstructions involving only single bundle, every attempt must be made to reconstruct conoid part of CC ligament as anatomically as possible.

In Vivo Three-dimensional Evaluation of the Functional Length of Glenohumeral Ligaments

  • Goto, Akira;Sahara, Wataru;Koishi, Hayato;Yoshikawa, Hideki;Sugamoto, Kazuomi
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2009.03a
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    • pp.174-174
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    • 2009
  • The acromioclavicular-hook-plate is one of the surgical treatments for distal clavicle fracture and traumatic acromioclavicular (AC) joint dislocation. Although this procedure can obtain rigid and accurate anatomical reduction of the AC joint, secondary widening of the hook-hole in the acromion is often seen during postoperative follow-up. This complication is owing to the high-degree of mobility of the AC joint. Therefore, it is important to evaluate the effect on these complications due to the position of the hook-hole. The purpose of the present study is to investigate three-dimensionally the effect due to the position of the hook-hole during arm abduction motion. We studied in vivo and three-dimensional kinematics of the normal shoulder joint with use of a markerless bone-registration technique. Magnetic resonance images of 14 shoulders of 7 healthy volunteers were acquired in 7 positions between $0^{\circ}$ and $180^{\circ}$ of abduction. We created three-dimensional computer models of the bones and the acromioclavicular-hook-plate. Based on the three-dimensional kinematics data, we simulated the widening of the hook-hole each different positioning of the hook-hole. The widths of the hook-holes almost linearly increased. And these widths significantly increased, when we put the hook-hole on the acromion from AC joint to 20 mm and 25 mm posterior position.

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A Case Report of an Immediate Frontal Sinus Reconstruction Using an Outer Table Calvarial Bone Graft in an En Bloc Manner (전두동 골절 환자에서 머리덮개뼈의 바깥판을 한판으로 이용한 즉시 전두동 재건술 1례)

  • Kim, Jong Do;Kim, Jeong Tae;Kim, Youn Hwan
    • Archives of Craniofacial Surgery
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    • v.12 no.1
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    • pp.33-36
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    • 2011
  • Background: In a frontal sinus reconstruction, the literature primarily recommends a surgical approach for definite treatment with the exception of for anterior wall fractures with no dislocation. Many studies have assessed a range of methods for the reduction of frontal sinus fractures. This paper presents a case, in whom the anterior wall of the frontal sinus was reconstructed using an outer table calvarial bone graft in an en bloc manner. Patient and methods: A 36-year-old male visited the emergency room with a heavy injury to the forehead. He was diagnosed with fractures of the anterior and posterior wall of the frontal sinus. The neurosurgeon removed the fractured area and repaired the meninges. Afterwards, cranialization was performed and the opening of the nasofrontal duct was obstructed. After fixing the removed bone to its original location, all fragments of fractured anterior wall were purged out and the anterior wall reconstructed using an en bloc calvarial bone graft. Results: In the post-operative 8 months period, there were no complications, the round contour of the forehead was expressed well and the patient was satisfied with the result. Conclusion: There are many methods for reconstructing the anterior wall of the frontal sinus. On the other hand, in cases of large fracture sites with many fractured bone fragments, en bloc harvesting of the outer table calvarial bone could be a better choice than making use of only plates and screws because this method shows a good results in terms of aesthetics with a low complication rate.