• 한국전문물리치료학회지
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• 제19권4호
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• pp.8-15
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• 2012

Posterior shoulder muscle tightness is frequently observed in shoulder impingement syndrome because tightness in the posterior portion of the shoulder muscles can cause anterior and superior translation of the humeral head in relation to the glenoid fossa. The purpose of this study was to determine the immediate effects of soft tissue massage on acromiohumeral distance (AHD), anterior translation of the humeral head, and glenohumeral (GH) range of motion (ROM) in subjects with posterior shoulder muscle tightness. Twenty-seven subjects with greater than $10^{\circ}$ difference in the range of GH horizontal adduction between right and left sides were recruited. The range of GH horizontal adduction and internal rotation were measured by a digital inclinometer. The AHD and anterior translation of the humeral head were measured using ultrasonography. A paired t-test was used to compare AHD, anterior translation of the humeral head, and the range of GH horizontal adduction and internal rotation before and after soft tissue massage. The results showed that AHD increased significantly (p<.05) and the anterior translation of humeral head decreased slightly, but not significantly (p=.40) after the soft tissue massage. Furthermore, the ROM of horizontal adduction and internal rotation in the GH joint increased significantly after the soft tissue massage (p<.05). These findings indicate that soft tissue massage on posterior shoulder muscle tightness is an effective method to increase AHD and ROM in the horizontal adduction and internal rotation of the GH joint.

• 대한족부족관절학회지
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• 제22권1호
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• pp.26-31
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• 2018

Purpose: The purpose of this study is to compare the clinical results between two different methods of hindfoot endoscopy to treat posterior ankle impingement syndrome. Materials and Methods: Between January 2008 and January 2014, 52 patients who underwent hindfoot endoscopy were retrospectively reviewed. Two methods of hindfoot endoscopy were used; Group A was treated according to van Dijk and colleagues' standard twoportal method, and group B was treated via the modified version of the above, using a protection cannula. For clinical comparison, the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, time required to return to activity, and the presence of complications were used. Results: There was no statistically significant difference in the AOFAS scores at the final follow-up, and there was also no statistically significant difference in the times for the scores to return to the preoperative level. There were no permanent neurovascular injuries and wound problems in either group. Conclusion: Use of protection cannula may provide additional safety during hindfoot endoscopy. We could not prove whether protection cannula can provide superior safety for possible neurovascular injury. Considering the possible safety and risk of using additional instrument, the use of this method may be optional.

• Clinics in Shoulder and Elbow
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• 제8권1호
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• pp.5-8
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• 2005

회전근 간의 질환은 과거 강직과 불안정성에 대한 연구가 주종을 이루었다. 동결견에 대한 치료로 회전근 간을 절제하는 것도 치료의 한 방법으로 사용되어 왔다. 불안정성에 대한 치료 중 회전근 간의 봉합술은 아직은 다른 치료 방법을 시행하고 추가적인 관절 운동 범위의 감소가 필요할 때 사용할 수 있는 보조적인 방법으로 사용하는 것이 좋을 것으로 보인다. 그 외의 회전근 간 자체 파열 등의 병변이 발생할 수 있으므로 수술시 반드시 확인해야 하는 구조물로 사료된다.

• 대한관절경학회지
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• 제16권1호
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• pp.79-86
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• 2012

충돌 증후군 및 회전근 개 파열에 있어 보존적 치료의 방법은 그 목적에 따라 염증과 통증의 완화를 위한 방법으로서 휴식, 진통 소염제 복용, 국소 스테로이드 주사제의 사용, 물리 요법 등을 사용할 수 있으며, 연부조직의 유연성 회복을 위한 스트레칭 운동과 기능의 회복을 위한 근력 강화 운동을 시행할 수 있다. 흔히 보존적 치료를 단계별로 구분해 보면 1단계로는 통증 완화를 위한 치료, 일상 생활 동작의 조절, 스트레칭 운동 등의 방법을 사용해 볼 수 있고, 2단계로는 전후방 회전근 개에서 시작하여 견갑골 주위 근육과 삼각근의 순서로 진행하는 근력 강화 운동을 시도해 볼 수 있으며, 3단계에서는 직업, 가사 및 취미 활동 등의 정상 생활로의 복귀를 위한 훈련과 유지 프로그램으로 구성해서 치료를 할 수 있다. 이와 같이 단계적으로 시행하게 되는 충돌 증후군 및 회전근 개 파열에 대한 보존적 치료의 핵심은 운동 치료라고 볼 수 있으며, 따라서 충돌 증후군 및 회전근 개 파열의 보존적 치료를 시행함에 있어 다양한 운동 치료 방법을 정확하게 숙지하고 환자의 상태에 맞게 적용하는 것이 중요하다고 할 수 있다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권4호
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• pp.168-172
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• 2014

Bilateral coronoid hyperplasia causes painless progressive trismus, resulting from coronoid process impingement on the posterior aspect of the zygomatic bone. The etiology of coronoid hyperplasia is unclear, with various theories proposed. An endocrine stimulus, increased temporalis activity, trauma, genetic inheritance and familial occurrence have all been proposed, but no substantive evidence exists to support any of these hypotheses. Multiplanar reformatting of axial scans and 3-dimensional reconstruction permit precise reproduction of the shape and size of the coronoid and malar structures, and relationships of all structures of the temporal and infratemporal fossae. This case shows remarkably increased mouth opening by coronoidectomy in a patient who complained of trismus due to hyperplasia of coronoid process.

• 대한족부족관절학회지
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• 제4권1호
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• pp.48-54
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• 2000

Haglund's syndrome produces retrocalcaneal bursitis or achilles tendinitis due to impingement of posterior superior bursal projection of calcaneus on insertional fibers of achilles tendon. Haglund's syndrome has been mainly associated with wearing rigid counter shoes and with athletes. We experienced three case of late sequelae of secondary Haglund's syndrome after malunion of tongue type calcaneus fracture. It is to be the first description of secondary Haglund's syndrome after calcaneus malunion and also the first report as the late complication of calcaneus fractures. Three cases were all tongue type intraarticular fractures and were treated with $45^{\circ}$ superior angle resection of superior calcaneal tuberosity. Clinical results by modified Rowe score were excellent with complete pain relief for all three cases.

• 대한관절경학회지
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• 제13권3호
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• pp.235-241
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• 2009

The development of good quality small-diametered arthroscopes and refined arthroscopic techniques has contributed to the improvement of the subtalar arthroscopy. The therapeutic indications are synovectomy, removal of loose bodies, debridement and drilling of osteochondritis dissecans, excision of subtalar impingement lesions and osteophytes, lysis of adhesions for post-traumatic arthrofibrosis, removal of a symptomatic os trigonum, calcaneal fracture assessment and reduction, and arthroscopic arthrodesis of the subtalar joint. The subtalar arthroscopy can be done in supine position using thigh holder or in lateral decubitus position. The arthroscope generally used is a 2.7-mm 30 degrees short arthroscope. Noninvasive distraction with a strap around the hindfoot can be helpful. Usually anterolateral, middle and posterolateral portals are utilized for inspection and instrumentation within the joint. Twoportal posterior subtalar arthroscopy in prone position can be performed as well with 4.0-mm 30 degrees arthroscope, depending on the type and location of the subtalar pathology. The subtalar arthroscopy is a technically demanding procedure, which requires proper instrumentation and careful operative technique. Possible complications are nerve damage and persistent wound drainage.

• 대한관절경학회지
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• 제15권2호
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• pp.108-112
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• 2011

목적: 퇴행성 내측 반월상 연골 퇴행성 파열 시 방사형 파열의 동반 여부 시 연골 후각부의 두께를 비교하고자 하였다. 대상 및 방법: 2000년 2월부터 2010년 2월까지 만 40세 이상에서 내측 반월상 연골의 퇴행성 변화 또는 파열이 자기공명영상으로 확인된 170예를 대상으로 하였다. 남자 57예, 여자 113예였고, 평균 연령은 55세였으며, 수평 파열과 함께 방사형 파열이 동반된 군(Group A), 연골 후각부의 횡 파열만 있는 군(Group B), 파열 없이 내측 반월상 연골의퇴행성 변화만 확인된 군(Group C) 으로 구분하여 후각부의 두께를 측정하고 연골의 퇴행정도를 grade 1, 2, 3로 평가하였다. 결과: 시상면에서 측정한 내측 반월상 연골 후각부의 평균 두께는 A, B, C 군이 각각 7.44 mm, 6.52 mm, 6.04 mm였고, A군이 B, C군보다 의미있게 연골 후각부의 두께가 증가하였으며 B군도 C군과 비교하여 연골 후각부의 두께가 증가하였다. 반월상 연골의 퇴행 정도는 A군이 가장 높았으며 A군이 B, C군보다 퇴행 정도가 의미있게 높았지만 A군과 B군과의 차이는 없었으며, B군이 C군보다 퇴행 정도가 높았다(p<0.05). 결론: 방사형 파열이 동반된 내측 반월상 연골 퇴행성 파열 시 반월상 연골 후각부의 두께가 증가하므로 치료 시 이를 고려해야 할 것으로 사료된다.

• Clinics in Shoulder and Elbow
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• 제20권2호
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• pp.68-76
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• 2017

Background: In general, the outcomes of arthroscopic repair for superior labrum anterior to posterior lesions (SLAP) are favorable, however, persistent pain and limitation of motion are not rare complications. One of the possible cause is a "knot-ache". This study evaluated the results of reoperation of symptomatic recurrent SLAP lesions and asked whether the knot is associated with postoperative complications. Methods: Between 2005 and 2015, a total of 11 patients who had undergone arthroscopic SLAP repair were reoperated for recurrent symptomatic SLAP lesion. By retrospective chart review, operative findings, the visual analogue scale for pain (pVAS), the range of motion (ROM), and functional scores were analyzed. Results: The mean age of the study participants was 38.3 years, and the mean follow-up period was 42.5 months. In the primary operation, there were nine cases of repairs with conventional knot-tying anchors and three cases with knotless anchors. Impingement of the knots during abduction and external rotation of the shoulder was observed in the all cases with knot-tying anchors. The mean pVAS, ROM, and functional scores significantly improved with reoperation. At the final follow-up, the mean satisfaction VAS was 8.3. Conclusions: The knots of suture anchor maybe a possible etiology of the pain, which we termed a "knot-ache". Considering that reoperation is performed due to pain after primary repair, the use of knotless suture anchor may have benefits of eliminating one of possible cause, "knot-ache". Therefore, authors suggest the use of knotless anchors during reoperation for recurrent or recalcitrant pain after primary SLAP repair.

• 대한관절경학회지
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• 제2권2호
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• pp.168-172
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• 1998

저자들은 관절운동의 장애 없이 양측 슬관절의 탄발음과 동통 및 파행을 주소로 한 6세 소아에서 관절경을 통해, 일반적인 탄발음의 원인이 아닌 외측 원판형 연골의 비후된 근위부착형의 리스버그 인대와 전방십자인대의 확장된 기시부의 충돌에 의해 탄발음이 유발된 1례를 발견하고 이를 관절경적으로 절제함으로서 치료하여 좋은 결과를 얻었기에 문헌 고찰과 함께 보고하는 바이다.