• Clinics in Shoulder and Elbow
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• 제7권2호
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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.

• 대한정형외과스포츠의학회지
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• 제1권1호
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• pp.61-64
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• 2002

소아에서후방십자인대의경골부착부위의견열골절은발생빈도가매우낮으며그보고된경우도드물다. 이에저자들은슬관절동통과종창을주소로내원하였으며, 슬관절 후방 슬와부에압통과 종창, 혈관절증, 후방 불안정성, 경골의 후방 전위, 슬관절신전제한소견을보이고있으며 방사선학적검사상후방십자인대의경골과간후면 부착부위에견열골절을 보이는13세 소년에게서 슬관절후방슬와부를 통한 견인 봉합술(pull-out suture)로 고정하여 치료한1예의 결과를 문헌 고찰과 함께보고하고자한다.

• Clinics in Shoulder and Elbow
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• 제25권4호
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• pp.288-295
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• 2022

Background: There is no standardized therapeutic strategy for locked posterior shoulder fracture-dislocation (PSFD), and no consensus exists on the analysis of preoperative factors. This retrospective study aimed to evaluate functional results and complications in a series of PSFD cases managed with open surgical treatment. Methods: Patients diagnosed with locked PSFD who underwent open surgical treatment with reduction and osteosynthesis between April 2016 and March 2020 were included. All participants were treated with open reduction and internal fixation. Functional assessment used the modified University of California, Los Angeles (UCLA) mod scale, American Shoulder and Elbow Surgeons (ASES) questionnaire, subjective shoulder value (SSV), and visual analog scale (VAS). Complications were evaluated clinically and radiologically by X-ray and computed tomography. Results: Twelve shoulders were included (11 patients; mean age, 40.6 years; range, 19- 62 years). The mean follow-up duration was 23.3 months (range, 12-63 months). The UCLA mod, ASES, SSV, and VAS scores were 29.1±3.7, 81.6±13.5, 78±14.8, and 1.2±1.4 points, respectively. The overall complication rate was 16.6%, with one case of post-traumatic stiffness, 1 case of chronic pain, and no cases of avascular necrosis. Conclusions: Open surgical treatment of locked PSFD can achieve good functional results. A correct understanding of these injuries and good preoperative planning helped us to achieve a low rate of complications.

• Journal of Korean Neurosurgical Society
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• 제40권5호
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• pp.387-390
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• 2006

We report a case of C1-2 instability with a bilateral high-riding transverse foramen that was treated with rod-screw fixation using a technique of translaminar rigid screw fixation of the axis. It is believed that a C1-2 fixation with bilateral C-2 translaminar screws has an important advantage over previously reported techniques of C1-2 fixation by eliminating the risk of injury to the vertebral artery during C2 screw placement.

• Clinics in Shoulder and Elbow
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• 제23권1호
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• pp.27-30
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• 2020

Osborne-Cotterill lesion is an osteochondral fracture located in the posterolateral margin of the humeral capitellum, which may be associated with a defect of the radial head after an elbow dislocation. This lesion causes instability by affecting the lateral ulnar collateral ligament over its capitellar insertion, which is associated with a residual capsular laxity, thereby leading to poor coverage of the radial head, and hence resulting in frequent dislocations. We present a 54-year-old patient, a physician who underwent trauma of the left elbow after falling from a bike and suffered a posterior dislocation fracture of the elbow. The patient subsequently presented episodes of instability, and additional work-up studies diagnosed the occurrence of Osborne-Cotterill lesion. An open reduction and internal fixation of the bony lesion was performed, with reinsertion of the lateral ligamentous complex. Three months after surgery, the patient was asymptomatic, having a flexion of 130° and extension of 0°, and resumed his daily activities without any limitation. Currently, the patient remains asymptomatic 2 years after the procedure. Elbow instability includes a large spectrum of pathological conditions that affect the biomechanics of the joint. The Osborne-Cotterill lesion is one among these conditions. It is a pathology that is often forgotten and easily overlooked. Undoubtedly, this lesion requires surgical intervention.

• 대한기계학회:학술대회논문집
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• 대한기계학회 2008년도 추계학술대회A
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• pp.1651-1654
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• 2008

Previous reports have introduced the technique of spinous process osteotomy to decompress spinal stenosis, a procedure which aims to afford excellent visualization while minimizing destruction of tissures not directly involved in the pathologic process. However, bio-mechanically it has not been investigated whether the sacrifice of posterior spinous process might have potential risk of spinal instability or not, even though supra-spinous and inter-spinous ligament are preserved. Therefore the aim of this study is to evaluate the bio-mechanical properties after spinous process osteotomiy, using finite element analysis. In the model of spinous process osteotomy the increase of stress in the disc and segmental rangesof motions were not changed significantly. It is due to the fact that the instability of lumbar spine has been maintained by the two-types of ligaments compared with the prior surgical technique. Therefore, according to the finite element result on this study, these osotetomy was considered to be a clinicallysafe surgical procedure and could not cause the instability of patient.

• 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.

• 대한기계학회논문집A
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• 제33권7호
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• pp.645-651
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• 2009

Previous studies have introduced the technique of spinous process osteotomy to decompress spinal stenosis, a procedure which aims to afford excellent visualization while minimizing destruction of tissues not directly involved in the pathologic process. However, biomechanically it has not been investigated whether the sacrifice of posterior spinous process might have potential risk of spinal instability or not, even though supra-spinous and inter-spinous ligaments are preserved. Therefore the aim of this study is to evaluate the biomechanical properties after spinous process osteotomy, using finite element analysis. The model of spinous process osteotomy exhibited no significant increase in disc stress or change in segmental range of motion. It is due to the fact that the instability of lumbar spine has been maintained by the two-types of ligaments compared with the prior surgical technique. Therefore, according to the finite element result on this study, this osotetomy was considered to be a clinically safe surgical procedure and could not cause the instability of the lumbar spine.

• Journal of Korean Neurosurgical Society
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• 제38권4호
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• pp.320-322
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• 2005

A 45-year-old man presented with lower back pain and pain in the right leg of 3years duration. A plain radiographic examination revealed grade I isthmic spondylolisthesis, with instability at L4-5. Computed tomography and magnetic resonance imaging demonstrated bilateral foraminal stenosis, with soft foraminal disc herniation on the right side at the L4-5 level. He underwent anterior lumbar interbody fusion[ALIF] with percutaneous posterior fixation[PF] at the L4-5 level. Without removing the posterior bony structures, removal of foraminal disc herniation and reduction of spondylolisthesis were successfully performed using ALIF with percutaneous PF. When there is no hard disc herniation or lateral recess stenosis, ALIF with percutaneous PF can be one of the treatment options for isthmic spondylolisthesis, even in the presence of foraminal disc herniation, as in our case.

• 대한인간공학회지
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• 제23권4호
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• pp.1-8
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• 2004

The objective of this study is to identify the effects of material position and physical fatigue on postural stability. Ten male subjects participated in this study. After bicycling exercises, their centers of pressure (COPs) were measured under four material handling positions and four excercise levels. The measured COPs were then utilized to calculate postural sway length in each experimental condition. Subjects' postural stability was quantified using the sway length. Results showed that the effect of different material handling position was significant on the postural sway length in both the posterior-anterior axis and the medio-lateral axis. Results also showed that the postural sway length was increased as physical fatigue accumulated, significantly in subject's posterior-anterior axis. The results imply that bearing a material on the back or front with both hands appeared to cause least sway length and instability.