• Title/Summary/Keyword: Retinaculum

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Recurrent Peroneal Tendon Dislocation - Four cases report - (만성 습관성 비골 건 탈구 - 4예 보고 -)

  • Kang, Ho-Jung;Kwon, Oh-Ryong;Shim, Dong-Joon;Kang, Eung-Shick;Hahn, Soo-Bong
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.100-105
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    • 2002
  • Purpose: The purpose of this study is to report four operative cases of recurrent peroneal tendon dislocation being effectively treated by superior peroneal retinaculum reconstructive operation and rerouting of calcaneofibular ligament. Materials and Methods: Four male adults with recurrent peroneal tendon dislocation including one of patient with redislocation after the treatment of plication of inferior peroneal retinaculum were followed up after being treated with superior peroneal retinaculum reconstructive operation using Achilles tendon and rerouting of calcaneofibular ligament. Results: All patients followed up for over one year revealed no pain and no redislocation. One patient who experienced redislocation after the treatment of plication of inferior peroneal retinaculum had no other complication after the treatment of superior peroneal retinaculum reconstructive operation using Achilles tendon. Conclusion: The reconstructive operation presumed to be effective for recurrent peroneal tendon dislocation.

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Usefulness of Ultrasound in Treatment of Patella Fracture (슬개골 골절 치료에서 초음파의 유용성)

  • Kim, Jung-Man;Nam, Ho-Jin;Ra, Ki-Hang;Park, Se-Wook
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.1
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    • pp.26-31
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    • 2010
  • Purpose: The purpose of this study is to evaluate the clinical usefulness of ultrasound in treatment of patella fracture. Material and Methods: Twenty cases of twenty patients with patella fracture radiographically from March, 2006 to September, 2009 were involved in this study, there were 8 males and 12 females, there were 13 right knees, 7 left knees, the average age was 43 years (range, 14~72 years). We decided the methods of treatment by using the ultrasound in conjunction with Drayer's test that examining the intactness of patella retinaculum. There were 10 transverse, 8 vertical and 2 comminuted fractures, we examined the patella retinaculum by using the ultrasound and performed Drayer's test. Results: In 12 cases of intact retinaculum, Drayer's test was negative and we allowed patients ambulation without surgical fixation especially. In 4 cases of completely ruptured retinaculum, Drayer's test was positive and we treated the patella fractures by the use of ORIF (open reduction and internal fixation) method, in 2 cases of partially ruptured retinaculum, Drayer's test was negative but displacement of fractures were more than 2 mm, we treated the patella fractures by the use of CRIF (closed reduction and internal fixation) method and obtained clinically satisfactory results. Conclusion: In conjunction with radiographs and Drayer's test, an ultrasound would be one of the useful diagnostic modality for determining treatment method of the patella fracture.

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Surgical Reconstruction of Lateral Capsule-ligament Complex with Reinforcement by Periosteal Flap of Distal Fibula and Inferior Extensor Retinaculum for Chronic Lateral Ankle Instability (만성 족관절 불안정성에서 하신전 지지대 및 원위 비골 골막을 이용한 해부학적 재건술)

  • Kim, Young-Chang;Gwak, Heui-Chul;Jung, Kyung-Chil;Choi, Jang-Seok;Seo, Jin-Hyuk
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.2
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    • pp.204-208
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    • 2007
  • Purpose: To evaluate the results of surgical reconstruction of lateral capsule-ligament complex with reinforcement by periosteal flap of distal fibula and inferior extensor retinaculum for chronic lateral ankle instability. Materials and Methods: From April 2003 to August 2006, 62 patients with chronic lateral ankle instability were operated. There were 38 males and 24 females with a mean age of 39.6 years (range, $18{\sim}61$ years). Mean follow-up period was 32 months (range, $10{\sim}48$ months). All patients were checked with preoperative ankle anteroposterior and lateral view, stress anterior drawer and varus test using Telos device. The clinical results were graded according to the VAS and AOFAS scale. Results: VAS score improved from preoperative 8.2 points to 3.1 points. There were 38 patients who were excellent (above 90 points), 18 who were good (between 76 and 90 points), 5 who were fair (between 60 and 75 points), and 1 who was poor (below 60 points) according to the AOFAS ankle and hindfoot scale. The excellent and good results amounted to 90.3%. Conclusion: Surgical reconstruction of lateral capsule-ligament complex with reinforcement by periosteal flap of distal fibula and inferior extensor retinaculum is believed to be a effective method for chronic lateral ankle instability.

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Ultrasonography Findings of the Carpal Tunnel after Endoscopic Carpal Tunnel Release for Carpal Tunnel Syndrome

  • Alex Wing Hung Ng;James Francis Griffith;Carita Tsoi;Raymond Chun Wing Fong;Michael Chu Kay Mak;Wing Lim Tse;Pak Cheong Ho
    • Korean Journal of Radiology
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    • v.22 no.7
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    • pp.1132-1141
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    • 2021
  • Objective: To investigate changes in the median nerve, retinaculum, and carpal tunnel on ultrasound after successful endoscopic carpal tunnel release (ECTR). Materials and Methods: This prospective study involved 37 wrists in 35 patients (5 male, 30 female; mean age ± standard deviation [SD], 56.9 ± 6.7 years) with primary carpal tunnel syndrome (CTS). An in-house developed scoring system (0-3) was used to gauge the clinical improvement after ECTR. Ultrasound was performed before ECTR, and at 1, 3, and 12 months post-ECTR. Changes in the median nerve, flexor retinaculum, and carpal tunnel morphology on ultrasound after ECTR were analyzed. Ultrasound parameters for different clinical improvement groups were compared. Results: All patients improved clinically after ECTR. The average clinical improvement score ± SD at 12 months post-ECTR was 2.2 ± 0.7. The median nerve cross-sectional area proximal and distal to the tunnel decreased at all time intervals post-ECTR but remained swollen compared to normal values. Serial changes in the median nerve caliber and retinacular bowing after ECTR were more pronounced at the tunnel outlet than at the tunnel inlet. The flexor retinaculum had reformed in 25 (68%) of 37 wrists after 12 months. Conclusion: Postoperative changes in median nerve and retinaculum parameters were most pronounced at the tunnel outlet. Even in patients with clinical improvement after ECTR, nearly all ultrasound parameters remain abnormal at one year post-ECTR. These ultrasound parameters should not necessarily be relied upon to diagnose persistent CTS after ECTR.

The Checkrein Deformity of Extensor Hallucis Longus Tendon and Extensor Retinaculum Syndrome with Deep Peroneal Nerve Entrapment after Triplane Fracture: A Case Report (원위 경골 삼면골절 후 발생한 장무지신전건의 체크레인 변형 및 심부비골신경이 포착된 신전지대 증후군: 증례 보고)

  • Gwak, Hyungon;Ahn, Jungtae;Lee, Jae Hoon
    • Journal of Korean Foot and Ankle Society
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    • v.25 no.3
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    • pp.145-148
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    • 2021
  • A checkrein deformity can occur after a distal tibiofibular fracture. Usually, a checkrein deformity due to a dysfunction of the extensor hallucis longus muscle is rarer than that of the flexor hallucis longus. Only a few related studies have been reported. The authors encountered an extensor hallucis longus checkrein deformity due to extensor retinaculum syndrome while managing a triplane fracture. In magnetic resonance imaging, an increase in the heterogeneous signal was observed on the T2-weighted images suggesting muscle necrosis or ischemic changes in a part of the extensor hallucis muscle. Postoperative great toe motor weakness, unintentional movement, sensory changes, and weakness improved spontaneously during the follow-up.

Operative Treatment of Chronic Recurrent Dislocation of Peroneal Tendon (A Case Report) (외상성 만성 비골건 탈구의 수술적 치료 (1예 보고))

  • Lee, Do-Young;Kang, Jae-Do;Lim, Moon-Sup;Yoon, Hyeong-Jo
    • Journal of Korean Foot and Ankle Society
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    • v.11 no.1
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    • pp.120-122
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    • 2007
  • Traumatic dislocation of the peroneal tendon is an infrequent injury. This injury is caused by forceful dorsiflexion of the foot accompanied by a powerful contraction of the peroneal muscles. This mechanism of injury tears the superior peroneal retinaculum and allows the tendons to snap anteriorly. We experienced a case of chronic recurrent dislocation of the peroneal tendon, which was treated by bone block surgery using autograft of lateral fibula and reattachment of the superior peroneal retinaculum. The clinical result was satisfactory.

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Operative Treatment of Acute Peroneal Tendon Subluxation in Athletes: A Case Report - 2 Cases (운동 선수에게 발생한 급성 비골건 아탈구의 수술적 치료: 증례 보고-2예)

  • Lee, Jun-Young;Lee, Ja-Yong
    • Journal of Korean Foot and Ankle Society
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    • v.9 no.1
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    • pp.117-120
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    • 2005
  • Acute subluxation of the peroneal tendon is an uncommon injury which is predominantly associated with a trauma. Traumatic peroneal tendon subluxation in athletes is an uncommon cause of ankle pain. As a result, the diagnosis is often delayed. Numerous surgical techniques have been described for chronic peroneal subluxation or dislocation, however reports in acute cases are rare. Authors experienced two cases of acute subluxation of peroneal tendon in athletes which were treated by simple primary repair of superior peroneal retinaculum with good results.

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Anatomical Study on the Heart Meridian Muscle in Human

  • Park Kyoung-Sik
    • The Journal of Korean Medicine
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    • v.26 no.1 s.61
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    • pp.11-17
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    • 2005
  • This study was carried out to identify the components of the human heart meridian muscle, the regional muscle group being divided into outer, middle, and inner layers. The inner parts of the body surface were opened widely to demonstrate muscles, nerves, blood vessels and to expose the inner structure of the heart meridian muscle in the order of layers. We obtained the following results; $\cdot$ The heart meridian muscle is composed of muscles, nerves and blood vessels. $\cdot$ In human anatomy, the difference between terms is present (that is, between nerves or blood vessels which control the meridian muscle and those which pass near by). $\cdot$ The inner composition of the heart meridian muscle in the human arm is as follows: 1) Muscle H-l: latissimus dorsi muscle tendon, teres major muscle, coracobrachialis muscle H-2: biceps brachialis muscle, triceps brachialis muscle, brachialis muscle H-3: pronator teres muscle and brachialis muscle H-4: palmar carpal ligament and flexor ulnaris tendon H-5: palmar carpal ligament & flexor retinaculum, tissue between flexor carpi ulnaris tendon and flexor digitorum superficialis tendon, flexor digitorum profundus tendon H-6: palmar carpal ligament & flexor retinaculum, flexor carpi ulnaris tendon H-7: palmar carpal ligament & flexor retinaculum, tissue between flexor carpi ulnaris tendon and flexor digitorum superficial is tendon, flexor digitorum profundus tendon H-8: palmar aponeurosis, 4th lumbrical muscle, dorsal & palmar interrosseous muscle H-9: dorsal fascia, radiad of extensor digiti minimi tendon & extensor digitorum tendon 2) Blood vessel H-1: axillary artery, posterior circumflex humeral artery H-2: basilic vein, brachial artery H-3: basilic vein, inferior ulnar collateral artery, brachial artery H-4: ulnar artery H-5: ulnar artery H-6: ulnar artery H-7: ulnar artery H-8: palmar digital artery H-9: dorsal digital vein, the dorsal branch of palmar digital artery 3) Nerve H-1: medial antebrachial cutaneous nerve, median n., ulnar n., radial n., musculocutaneous n., axillary nerve H-2: median nerve, ulnar n., medial antebrachial cutaneous n., the branch of muscular cutaneous nerve H-3: median nerve, medial antebrachial cutaneous nerve H-4: medial antebrachial cutaneous nerve, ulnar nerve H-5: ulnar nerve H-6: ulnar nerve H-7: ulnar nerve H-8: superficial branch of ulnar nerve H-9: dorsal digital branch of ulnar nerve.

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Trigger Wrist with Carpal Tunnel Syndrome Accompanied with Trifid Median Nerve: A Case Report and Literature Review

  • Sangho Oh
    • Archives of Plastic Surgery
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    • v.49 no.6
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    • pp.750-754
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    • 2022
  • Trigger wrist, characterized by a clicking or snapping sensation around the wrist joint during finger or wrist motion, and bifid or trifid median nerve, which occurs in carpal tunnel syndrome along with anatomical variation of median nerve, are rare conditions. We report the case of a patient with a thickened tendon caused by severe tenosynovitis and flexor tendon subluxation to the hamate hook due to bowing of the flexor retinaculum, thereby resulting in trigger wrist as well as an anatomical median nerve variation (bifid median nerve in the right wrist and trifid median nerve in the left wrist). A 59-year-old housewife visited our hospital with bilateral fingertip numbness, tingling sensation, and aggravated severe night cramping that began 2 months ago. She also complained about trigger wrist during small finger flexion. Based on magnetic resonance imaging, ultrasonography, and nerve conduction study, trifid median nerve and bilateral severe median nerve neuropathy of the wrist were diagnosed; therefore, transverse carpal tunnel release and exploration under wide-awake anesthesia were planned. Intraoperative findings showed trifid and bifid median nerves in left and right wrists, respectively. Additionally, bowing of flexor retinaculum and severe flexor tendon tenosynovitis were observed. Tenosynovitis with thickened flexor sheath resulted in subluxation of the small finger flexor tendon above the hamate hook. After transverse carpal ligament release with antebrachial fascia release and tenosynovectomy, subluxation of the flexor tendon was resolved. At 6 months postoperatively, the tingling and dullness in fingertips also resolved, and no trigger wrist or any other complications were noted.

Identification of Streptomyces species antagonistic to Fusarium solani or Cylindrocarpon destructans causing ginseng root rots (인삼근부(人蔘根腐) 병원균(病原菌), Fusarium solani 및 Cylindrocarpon destructans에 길항적(拮抗的)인 Streptomyces species의 분류동정(分類同定))

  • Shim, Jae-Ouk;Lee, Min-Woong
    • The Korean Journal of Mycology
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    • v.19 no.1
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    • pp.66-73
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    • 1991
  • Among 110 isolates of actinomycetes isolated from ginseng pathogen-suppressive soils, the three actinomycetes showing the effective controls to Fusarium solani or Cylindrocarpon destruc­tans causing ginseng root rots were identified according to their morphological, cultural and physio­logical characteristics on various culture media. Spore chains of K 6-2, S 2-1 and Y 2-2 were Spira (S), Retinaculum-apertum (RA) and Rectus-flexibilis (RF), respectively. Spore surfaces of K 6-2 were spiny, whereas S 2-1 and Y 2-2 were all smooth. Aerial mass colors of 3 isolates were gray series. As a result of various tests, they were identified as Streptomyces variabilis, Streptomyces virgi­niae and Streptomyces griseo/us, respectively.

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