• Title/Summary/Keyword: collateral ligament

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Traumatic Dynamic Hallux Varus (A Case Report) (외상성 역동적 무지 내반증(1예 보고))

  • Yim, Soo-Jae;Lee, Young-Koo;Kim, Jin-Su;Kim, Chan-Ho;Kang, Hee-Kyung
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.193-196
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    • 2009
  • The first metatarsophalangeal joint injury is common in professional soldiers and athletes. But this was rarely reported. A professional soldier has varus instability in the first metatarsophalangeal joint due to hyperextension. In the MR Imaging, weavy appearance in lateral collateral ligament and high signal change in plantar plate was shown. So he has surgical treatment using reconstructive procedure. At first, $4^{th}$ extensor digitorum longus tendon was splitted longitudinally and harvested, second triangular shape reconstruction on lateral joint line was done using harvested tendon. One year later, fifteen degrees was limited compared with intact side. Reconstruction using $4^{th}$ extensor digitorum longus tendon in traumatic dynamic hallux varus was good method.

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Osborne-Cotterill Lesion a Forgotten Injury: Review Article and Case Report

  • Vargas, Daniel Gaitan;Woodcock, Santiago;Porto, Guido Fierro;Gonzalez, Juan Carlos
    • Clinics in Shoulder and Elbow
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    • v.23 no.1
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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.

Treatment of Tibial Condyle Fracture (경골과 골절의 치료)

  • Lee, Dong-Chul;Shon, Oog-Jin;Park, Sung-Hyuk
    • Journal of Yeungnam Medical Science
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    • v.20 no.2
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    • pp.177-186
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    • 2003
  • Background: Clinical and radiological results based on fracture types and associated injuries after the treatment of tibial plateau fracture were evaluated for analyzing prognostic factors. Materials and Methods: From June 1997 to June 2002, 50 cases were followed for at least 1 year. Mean age was 47.4 years, and mean follow period was 30.0 months. Fracture classification was performed by the Schatzker method. Clinical and radiological evaluation were performed by the Porter and Rasmussen method. Evaluation was based on degree of reduction and associated injuries, etc. Results: The most common cause of injury was traffic accident (37 cases, 74%), The common fracture types by Schatzker classification were type II (14 cases) and VI (12 cases). Methods of treatment were screw fixation (15 cases), plate and screw (21 cases), external fixator (5 cases), and conservative treatment (9 cases). The most common associated injuries were ipsilateral fibular fracture (18 cases) and MCL (medial collateral ligament) injury (8 cases). Conclusion: Acceptable results after treatment of tibial plateau fracture were obtained from the anatomical reduction group, non-associated injury group, the young age group, and the early ROM (range of motion) beginning group.

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Overview of the PCL Reconstruction (후방 십자 인대 손상 치료의 개관(over view))

  • Jung, Young Bok
    • Journal of the Korean Arthroscopy Society
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    • v.2 no.1
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    • pp.1-3
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    • 1998
  • The PCL reconstruction in chronic isolate PCL reconstruction was still controversy. 1) In isolate PCL deficient knee, functionally not so bad as like ACL deficient knee. 2) The result of the PCL reconstruction was not as good as ACL reconstruction. Therefore, isolate PCL injuries has been treated as nonoperatively. Hey Grovere, who was the first to attempt an intra-articular reconstruction of the PCL, utilized the semi-tendinous tendon other static procedures have been described in only a few cases with very limited follow-up. Dynamic procedures utilizing the medial head of the gastrocnemius has been reported by Hugston and Degenhardt, Kennedy and Grainger, and Insall and Hood. These procedures did not improve static stability. Dr Clancy, who was introduce the use of BPTB for the PCL reconstruction transtibial and femoral tunnel. From 1995, untill early 1990 PCL reconstruction was done as tend as placement of the isometric point. Physiometic placement of Anatomical placement of the femoral tunnel in PCL reconstruction were introduced in 1995. Tibial Inlay Technique was reported by Dr Berg in 1995. The main advantage of the tibial Inlay Technique was to avoid fraying of the graft at the posterior tibial tunnel orifice. In complete PCL ruptured and severely posterior unstable knee, dual femoral tunnel technique will be to get better result than one bundle technique. To achieve restoration of normal posterior laxity, it is critical to address the posterior as well as the posterolateral structures. Futher research is necessary to evaluate new surgical approches such as double-bundle reconstructions and tibial inlay techniques as well as improved techniques for capsular and collateral ligament injuries.

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Clinical observations on treatment of ankle-sprain (족관절 염좌의 치료에 대한 임상적 고찰)

  • You, Tae-seop;Park, Dong-suk;Kang, Sung-keel
    • Journal of Acupuncture Research
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    • v.21 no.1
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    • pp.168-175
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    • 2004
  • Objective: This report was designed to investigate characteristic of ankle sprain due to cause, degree of injury, treatment process, sex, age etc Methods: We selected 36 patients who visited our clinic at last over two times complaining of ankle-sprain since 8th, March, 2002. Results: The results were summarized as follows. 1. The major cause of ankle-sprain was injury of lateral collateral ligament. 2. Ankle-sprain was distinguished three degree, and generally presented pain, regional tenderness, swelling, limited movement, muscle spasm, redness, deformity. 3. In early stage of ankle-sprain, ice massage, compression, elevation, rest were very important. 4. In oriental medicine, the principle of treatment were promoting blood circulation to remove blood stasis, relaxing muscles and tendons and activating the flow of Gi and blood in the channels and collaterals, reducing edema or swelling, and alleviating pain. 5. There were more effective result to using three-edged needle with acupuncture. Conclusions: Ankle-sprain were treated successfully using acupuncture and three-edged needle.

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New Technique for Posterolateral Instability of The Knee: Posterolateral Reconstruction Using The Tibialis Posterior Tendon Allograft (슬관절 후외측 불안정성 치료의 새 기법: 동종 후경골건을 이용한 후외측 재건술)

  • Kim Sung-Jae;Ryu Sang-Wook;Cheon Yong-Min;Yong Suk-Won;Kim Bo-Ram
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.2 no.2
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    • pp.136-141
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    • 2003
  • Posterolateral instability of the knee is known as one of the most challenging injuries . Although several procedures have been designed for the posterolateral instability, there is no gold standard management yet. We present a technique for posterolateral instability of the knee using tibialis posterior tendon allograft, which reconstructed lateral collateral ligament and popliteal tendon.

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Reconstruction of Recurrent Posterolateral Rotatory Instability of the Elbow - A Case Report - (재발성 주관절 후외방 회전 불안정성의 재건술 - 증예보고 -)

  • Jeon In Ho;Kyung Hee Soo;Kim Poong Taek;Ihn Joo Chul
    • Clinics in Shoulder and Elbow
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    • v.4 no.2
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    • pp.191-195
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    • 2001
  • Posterolateral rotatory instability is the most common pattern of elbow instability especially which is recurrent, and is usually post-traumatic because of inadequate soft tissue healing. The lateral ulnar collateral ligament was reconstructed by using ipsilateral palmaris longus tendon. Functionally good result was obtained. This is a case report illustrating the posterolateral rotatory instability of the elbow and its reconstruction with palmaris longus.

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Epicondylitis (상과염)

  • Chung Sun-Gun
    • Clinics in Shoulder and Elbow
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    • v.8 no.2
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    • pp.81-87
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    • 2005
  • Epicondylitis, as a tendinopathy characterized by fibroblast and microvascular hyperplasia, is a common musculoskeletal problem especially related with repetitive hand and wrist motion. It has a prevalence of between 0.2% and 5% in general population depending on the amount of exposure to manual labor jobs. Although it is known that the pathological lesions lie in the flexor or extensor common tendons, there could be collateral ligament lesions and/or reactive synovitis accompanied, which may make a case unresponsive to the treatment aimed only at the tendinopathy. Epicondylitis is easy to diagnose with typical pain, tenderness, and positive provocation tests. However, many conditions can mimic epicondylitis that further imaging or electrodiagnostic studies should be undertaken to exclude other possible problems. Ultrasonography provides information about the existence and extent of tendinopathy with relatively high specificity. Magnetic resonance imaging is often required to rule out other problems and confirm the diagnosis of the cases intractable to long term treatment. Many options of treatment are available for epicondylitis while numerous conflicting evidences have been noted, debating one treatment method is better than the others. Since it was reported that over 80% of epicondylitis improved within a year no matter what was done as treatment, it is a challenge to make accurate diagnosis and combine effective therapeutic regimens for the 20% of intractable cases.

Arthroscopic Reduction of Irreducible Knee Dislocation - A Case Report - (정복 불가능한 슬관절 탈구의 관절경적 치료)

  • Jeong, Jin-Young
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.161-164
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    • 2009
  • Irreducible knee dislocation is a rare injury and often need an open procedure with ligaments reconstruction. This report describes a case of arthroscopic treatment of a patient with traumatic knee dislocation unable to reduce in a closed method. MRI revealed incarceration of the medial collateral ligament and capsule in the medial compartment. And arthroscopic examination confirmed incarcerated medial capsuloligamentous structures which prevented the knee from reduction. Arthroscopic procedure without ligaments reconstruction was complete when the medial condyle was well visualized and the knee reduced. After 4 weeks of immobilization in extension, range of motion exercise and gradual increases in weight bearing was allowed. At the 3- year follow-up, mild laxity was remained but the patient did not have any discomfort of doing ADL activity and showed full range of motion of the knee.

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Youth throwing athletes do not show bilateral differences in medial elbow width or flexor tendon thickness

  • Morrow, Rudolph M.;McIlvian, Gary E.;Johnson, Jenifer;Timmons, Mark K.
    • Clinics in Shoulder and Elbow
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    • v.25 no.3
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    • pp.188-194
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    • 2022
  • Background: Medial elbow laxity develops in throwing athletes due to valgus forces. Medial elbow instability in professional, collegiate, and high school athletes is well documented; however, the medial elbow of young throwing athletes has received less attention. This study investigated the medial elbow and common flexor tendon during applied elbow valgus stress of youth baseball players. Methods: The study included 15 participants. The medial elbow width and thickness of the common flexor tendon were measured on ultrasound images. Results: No significant side differences in medial elbow width or common flexor tendon were found at rest or under applied valgus stress. At rest, the medial elbow joint width was 3.34±0.94 mm on the dominant side and 3.42±0.86 mm on the non-dominant side. The dominant side increased to 3.83±1.02 mm with applied valgus stress, and the non-dominant side increased to 3.96±1.04 mm. The mean flexor tendon thickness was 3.89±0.63 mm on the dominant side and 4.02±0.70 mm on the non-dominant side. Conclusions: These findings differ from similar studies in older throwing athletes, likely because of the lack of accumulated stress on the medial elbow of youth throwing athletes. Maintaining elbow stability in young throwing athletes is a vital step to preventing injury later in their careers.