• Journal of Trauma and Injury
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• v.32 no.1
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• pp.51-59
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• 2019

Unstable pelvic ring lesions are usually treated with internal fixation. In patients presenting clinical instability or soft tissue complication risk, external fixation is a safe treatment option. However, pin tract infection, insufficient biomechanical properties, difficulty sitting and changing decubitus are important drawbacks related to the treatment. The present study reports the association of anterior and posterior subcutaneous internal fixation by applying spine-designed implants on the pelvic ring disruption: supra-acetabular pedicle screws with an interconnecting rod (Infix), plus posterior transiliac fixation with the same system, which the authors have named the "Hula Hoop Technique".

• The Journal of Korean Physical Therapy
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• v.23 no.4
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• pp.15-22
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• 2011

Purpose: The purpose of this study was to investigate the relationship between hip abductor muscle strength and lumbar instability in patients with chronic low back pain. Methods: Fifty-two female patients were recruited for this study. The patients' history was recorded and was used to determine the general characteristics of the female complaints. The women were additionally examined to determine whether the level of pain was characteristic of patients with chronic lumbar instability. The following tests were also carried out in the subjects during the examination: 1) the prone instability test. 2) the test for aberrant movement patterns during lumbar flexion test. 3) the straight leg raising test. 4) posterior-to-anterior mobility test, and 5) the test for age and strength of the hip abductor muscle following assessment of the dominant side. In particular, hip abductor muscle strength was evaluated using a dynamometer. Results: The test results showed that the number of positive responses for the five types of lumbar instability tests performed, was significantly related to the strength of the hip abductor muscle. The average hip abductor muscle strength in total subjects was $72.89{\pm}7.66N$, whereas the average hip abductor muscle strength in subjects who showed positive responses to more than four out of the five tests, was $44.70{\pm}5.79N$. Conclusion: The results demonstrated that the hip abductor muscle strength and lumbar instability were negatively correlated. The lower was the strength of the hip abductor muscle, the higher was the possibility of lumbar instability.

• Clinics in Shoulder and Elbow
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• v.19 no.3
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• pp.155-162
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• 2016

Background: The study aimed to determine the type of capsular insertion and the extent of capsular elongation in anterior shoulder instability by quantitatively evaluating their computed tomography arthrographic (CTA) findings, and to investigate the correlation of these parameters with surgical outcomes. Methods: We retrospectively reviewed 71 patients who underwent CTA and arthroscopic capsulolabral reconstruction for anterior shoulder instability between April 2004 and August 2008. The control group comprised 72 patients diagnosed as isolated type II superior labrum anterior to posterior (SLAP) lesion during the period. Among the 143 patients, 71 were examined with follow-up CTA at an average 13.8 months after surgery. It was measured the capsular length and cross-sectional area at two distinct capsular regions: the 4 and 5 o'clock position of the capsule. Results: With regards to the incidence of the type of anterior capsular insertion, type I was more common in the control group, whereas type III more common than in the instability group. Anterior capsular length and cross-sectional area were significantly greater in the instability group than in the control group. Among patients of the instability group, the number of dislocations and the presence of anterior labroligamentous periosteal sleeve avulsion lesion were significantly associated with anterior capsular redundancy. Postoperatively, recurrence was found in 3 patients (4.2%) and their postoperative capsular length and cross-sectional area were greater than those of patients without recurrence. Conclusions: Capsular insertion type and capsular redundancy derived through CTA may serve as important parameters for the management of anterior shoulder instability.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.1
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• pp.21-29
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• 2023

Purpose : Using a smartphone while walking districts attention and increases the risk of losing balance or falling. Ankle instability is caused by decreased muscle strength and decreased neuromuscular ability leading to postural control problems. Dual tasks increases the risk of falls by reducing postural control in adults with ankle instability. This study aimed to investigate the effect of performing a dual task on balance and muscle activity in adults with ankle instability using a smartphone. Methods : Forty-nine individuals with ankle instability participated in this study. A game of finding the wrong picture was performed using a smartphone in the dual task, and only looking at the blank screen of a smartphone was evaluated in the single task. The participants randomly performed single and dual task to evalutate balance and muscle atcitivy. Balance was evaluated using the Biodex balance system (BBS), and muscle activity was evaluated using surface EMG. Muscle activity of the gastrocnemius and tibialis anterior was measured at the same time as balance. Results : The results of this study showed that overall, anteior/posterior, and medial/lateral balance indices all showed significant differences when performing the dual task compared with those during the single task (p<.05). The muscle activity results showed a significant difference compared with that of the gastronemius muscle on the nondominant side during the dual task (p>.05). Conclusion : The results of this study showed that maintaining balance is more difficult when performing the dual task than during the single task, and only the muscle activity of the nondominant gastrocnemius muscle decreased. The dual task causes a decrease in concentration for postural control, which negatively affects postural stability. Individuals with ankle ankle instability should refrain from performing dual tasks, such as using smartphones, to prevent ankle damage.

• Journal of Korean Neurosurgical Society
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• v.37 no.3
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• pp.201-206
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• 2005

Objective: To evaluate the accuracy and safety of C1-C2 transarticular screw insertion, we retrospectively review surgical records and postoperative radiological findings. Methods: From January 2001 to October 2003, the C1-C2 transarticular screw fixation and posterior wiring with iliac bone grafts was performed in 16 patients. 6 patients had rheumatoid arthritis which caused cervical instability, 3 patients had os odontoideum, 3 patients had type 2 odontoid process fracture, 3 patients had traumatic transverse ligament injury and 1 patients who had been managed with C1-C2 wire fixation had psoriatic arthritis. Results: Osseous fusion was documented in 15 patients(93.8%). Only one patient was recorded screw loosening because of postoperative infection. One patient had only one screw placed because of abnormal anatomical structure, one patients was breakage of a Kirschner wire, and one screw was medial location to lateral mass of C1, but clinical results was excellent and radiological instability was not noted. Conclusion: The author's experience demonstrates that C1-C2 transarticular screw fixation with wired bone graft is a safe procedure with higher fusion rate but precaution is needed to avoid the neural damage, vertebral artery injury, and hardware failure.

• Physical Therapy Korea
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• v.23 no.1
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• pp.80-86
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• 2016

Background: Prone hip extension (PHE) can be performed to measure the lumbopelvic motor patterns and motions. Imbalances in lumbopelvic muscle activity and muscle weakness can result in instability including pain in lumbopelvic region. The posterior oblique sling (POS) muscles contribute to dynamic lumbopelvic stability. In addition, POS are anatomically aligned with the trapezius muscle group according to shoulder positions. Objects: This study compared the electromyography (EMG) activity of POS and pelvic compensations during PHE with and without pre-activation of lower trapezius muscle (lowT). Methods: Sixteen healthy males were recruited. PHE was performed in randomized order: PHE with and without lowT pre-activation. Surface EMG signals were recorded for biceps femoris (BF), gluteus maximus (GM) (ipsilateral), lumbar multifidus (MF) (bilateral), and the lowT (contralateral). An electromagnetic tracking motion analysis was used to measure the angle of pelvic rotation and anterior tilting. Results: The ipsilateral GM and bilateral MF EMG amplitudes were greater during PHE with lowT pre-activation compared to PHE without lowT pre-activation (p<.05). The BF amplitude during PHE without lowT pre-activation was significantly greater than that during PHE with lowT pre-activation (p<.05). The angles of pelvic rotation and anterior tilting during PHE with lowT pre-activation were significantly smaller compared to PHE without lowT pre-activation (p<.05). Conclusion: PHE with lowT pre-activation, which is aligned with the POS, showed more increased MF and GM muscular activity with smaller lumbopelvic compensations in rotation and anterior tilting compared to PHE without lowT pre-activation.

• Clinics in Shoulder and Elbow
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• v.21 no.1
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• pp.37-41
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• 2018

Background: The purpose of this study is to evaluate results of superior labrum anterior to posterior (SLAP) repairs and debridement of type II SLAP lesions combined with Bankart lesions. Methods: Between 2010 and 2014, total 58 patients with anterior shoulder instability due to a Bankart lesion combined with a type II SLAP lesion were enrolled. Patients were divided into two groups: group C consisted of 30 patients, each with a communicated Bankart and type II SLAP lesion and group NC consisted of 28 patients, each with a non-communicated Bankart and type II SLAP lesion. Bankart repairs were performed for all patients. SLAP lesions were repaired in group C and debrided in group NC. Clinical results were analysed to compare groups C and NC by using the visual analogue scale pain score, American Shoulder and Elbow Surgeons score, Constant scores, Rowe score for instability and range of motion assessments. Results: The clinical scores were improved in both groups at final follow-up. Also, there were no differences between two groups. No significant difference was found in terms of the range of motion measured at the last follow-up. The number of suture anchors used was significantly higher in group C than in group NC (5.6 vs. 3.8; p=0.021). Conclusions: In this study, it is considered that Bankart repair and SLAP debridement could be a treatment option in patients with a non-communicated type II SLAP lesion combined with a Bankart lesion (study design: IV, therapeutic study, case series).

• Journal of the Korean Society of Physical Medicine
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• v.8 no.3
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• pp.361-368
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• 2013

PURPOSE: The purpose of this study was to investigate the comparison of balance on Stable Ankle(SA), Instability Ankle(IA) using Cumberland Ankle Instability Tool(CAIT). METHODS: Total 54(SA: 27, IA: 27) subjects were volunteered to participate in the study. SA can be defined CAIT score ${\geq}28$, with no history of injury to ankle. IA can be defined persisting symptoms of giving way and ${\leq}24$ on the CAIT after ankle sprain. the balance measured using Biodex Balance System$^{(R)}$(BBS). BBS instability protocols used static, dynamic balance level less stable(2), moderate stable(4) and level more stable(8). RESULTS: There were significant differences at overall, Anterior-Posterior(AP), Medial-Lateral(ML) of static balance, dynamic balance level 2, 4. The dynamic balance level 8 found significant difference at ML, but not found significant differences at overall, AP. CONCLUSION: We suggest that CAIT is acquired more exact information for IA intervention, as balance measured.

• Clinics in Shoulder and Elbow
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• v.7 no.2
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• pp.57-64
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• 2004

The purposes of this study were to evaluate the presence or absence of pain with the jerk test as a predictor of the success of nonoperative treatment for posteroinferior instability of the shoulder and to identify pathologic lesion responsible for the pain in the jerk test. Eighty-nine shoulders(81 patients), which had posteroinferior instability with positive posterior clunk in the jerk test, were nonoperatively treated. The patients were divided into two groups with respect to the presence of pain in the jerk test: painless jerk group(54 shoulders) and painful jerk group(35 shoulders). Response to the nonoperative treatment was evaluated after at least 6 months rehabilitation program. Patients who did not respond to the rehabilitation underwent arthroscopic examination to identify any pathologic lesion. The painful jerk group had higher failure rate with nonoperative treatment (p<0.001). In the painless jerk group, fifty shoulders (93%) responded to rehabilitation program after a mean of 4 months. Four shoulders(7%) were unresponsive to the rehabilitation. In the painful jerk group, five shoulders(16%) were successful with the rehabilitation while the other thirty shoulders(84%) failed. All 34 shoulders, which were unresponsive to the rehabilitation, had a variable degree of posteroinferior labral lesions. In conclusion, the jerk test is a hallmark for predicting the prognosis of nonoperative treatment in the posteroinferior instability. Shoulders with symptomatic posteroinferior instability and a painful jerk test have posteroinferior labral lesion.

• Journal of Korean Orthopaedic Sports Medicine
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• v.1 no.1
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• pp.61-64
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• 2002

The authors report one case of isolated avulsion fracture of the tibial attachment of the posterior cruciate ligament. A 13 years old boy was admitted for right knee pain and swelling after the soccer injury on his knee. Hemarthrosis and posterior instability were present. Simple roentgenographic examination showed an isolated avulsion fracture of the tibial attachment of the posterior cruciate ligament. Open approach through the popliteal fossa was used and bony fragment was fixed into its bed using pull-out sutures. Postoperatively, a long leg cast was applied for 4 weeks. The patient was followed for 6 months. He returned to his previous activity levels. There was no residual laxity. Isolated avulsion of the posterior cruciate ligament from the tibia before the epiphyseal fusion is very rare in children. We reported one case of our experience and its result.