• Title/Summary/Keyword: joint dislocation

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Arthroscopic Stabilization of Acromioclavicular Joint Dislocation using TightRope® (TightRope®를 이용한 내시경하 급성견봉쇄골관절 탈구의 고정술 메리놀병원 정형외과)

  • Choi, Sun-Jin;Park, Jong-Hoon;Lee, Hyeong-Seok
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.172-176
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    • 2008
  • Purpose: The proper surgical methods for treating acromioclavicular joint dislocation is still controversial. New methods should provide better early motion with sufficient strength. Materials and Methods: We performed arthroscopic stabilization using TightRope$^{(R)}$ (Arthrex, Inc, Naples, FL) in 10 cases of acromioclavicular joint dislocation between April, 2007, and December, 2007, and followup for a minimum of 10 months. We performed radiologic evaluation by comparing the clavicle anteroposterior radiograph with the contralateral one. Clinical evaluation was made for pain, function, and range of joint motion by Imatani's methods. Results: In clinical evaluation, 6 cases were excellent, 3 cases were good, and 1 case was poor. In radiologic evaluation, 9 cases were excellent and 1 case was poor. Redislocation occurred in 1 case. Conclusion: During short-term followup, 9 of 10 patients who underwent arthroscopic stabilization using TightRope$^{(R)}$ had excellent results in Imatini tests and radiologic evaluation, except 1 patient with redislocation.

The Modified Phemister Operation with the Suture Anchor Added for the Augmentation of Conoid Ligament in Acute Acromioclavicular Dislocation (견봉쇄골 관절의 급성 탈구에서 원추인대 기능의 강화를 위한 봉합 나사못을 추가한 변형된 Phemister 술식)

  • Moon, Gi-Hyuk;Nam, Il-Hyun;Lee, Yeong-Hyun;Kim, Ki-Choul;Lee, Jae-Hoon;Ahn, Gil-Yeong
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.34-39
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    • 2010
  • Purpose: The purpose of this study was to present methods and results for the modified Phemister operation, with a suture anchor added for augmentation of the conoid ligament in cases of acute dislocation of the acromioclavicular joint. Materials and Methods: We evaluated 14 cases of acute dislocation of the acromioclavicular joint. This included 11 cases of Rockwood type 3, and 3 cases of type 5. The mean age of patients was 45.2 years. We operated on them using an anchor for augmentation of the conoid ligament in the modified Phemister operation. The average follow-up period was 14 months and post-operative clinical analysis was conducted using the Weitzman classification, VAS Score, Constant Score and KSS Score. Results: According to Weitzman scores, 13 cases were evaluated as excellent, and one case was good. They had mean joint ranges of forward elevation of $170.7^{\circ}$, lateral elevation of 166.4, external rotation of 68.2, and internal rotation to the level of T7. The mean VAS Score was 1.9, mean Constant Score 90.8, and the mean KSS Score 91. Radiologic analysis indicated that all cases had a good result. Conclusion: The modified Phemister operation with a suture anchor added for augmentation of the conoid ligament is very effective clinically in acute dislocations of the acromioclavicular joint.

Inferior Capsular Shift for Multidirectional Shoulder Instability in Contact Sports Athletes (접촉성 운동 선수에서 견관절 다방향 불안정성에 대한 하방 관절막 이동술)

  • Choi Chong-Hyuk;Yun Kyung-Hwan;DJ Ogilvie-Hanis
    • Clinics in Shoulder and Elbow
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    • v.3 no.1
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    • pp.10-19
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    • 2000
  • The aims of this retrospective study were to evaluate the results of inferior capsular shift operation which were approached anteriorly or posteriorly according to a main instability direction in contact sports population who had multidirectional shoulder instability. Fifty-three shoulders in 47 athletes who engaged in contact sports underwent an anterior or posterior inferior capsular shift procedure for the correction of multidirectional instability of the shoulder joint. The surgical approach was selected according to the predominant direction of the instability. Follow up was average of 42 months(24∼73 months). After anterior inferior capsular shift, anterior dislocation was recurred in three shoulders, posterior dislocation in one, and inferior dislocation in two shoulders. After posterior inferior capsular shift, one dislocation occurred anteriorly, one inferiorly and one posteriorly. The excessive tightening of capsule or improper diagnosis could be causative factors for the development of dislocation in the opposite direction to the preoperative major instability. Of six patients who could not return to their sports, five had bilateral repairs. Successful repair based on the criteria of the American shoulder and elbow association was achieved in 92% of anterior repairs, and 81 % of posterior repairs.

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Simple Anterior Dislocation of the Elbow - Case Report (주관절의 전방 단순 탈구 - 증례보고)

  • Lee Bong-Jin;Lee Sung-Rak;Kim Seong-Tae
    • Clinics in Shoulder and Elbow
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    • v.8 no.2
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    • pp.181-186
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    • 2005
  • An anterior dislocation of the elbow without a fracture of the olecranon is an extremely rare injury. This paper reports a 36-year-old male who stumbled and fell on his outstretched hand during a soccer game. The anteroposterior and lateral radiographs indicated a simple anterior dislocation of the elbow, which was reduced using a closed method. The elbow joint was stable in the range of motion, but the sensation of the two ulnar digits was still reduced. MRI was useful for the identification of the pathoanatomy. At the follow-up examination three months after the initial trauma, the hypesthesia has fully recovered and the patient regained the full range of the elbow and forearm motion without pain and instability. After 18 months, the patient had a normal elbow function, and could play various sports. If an anterior elbow dislocation is detected early, a closed reduction with careful pathoanatomical considerations would be successful.

CLINICAL AND ETIOLOGICAL INVESTIGATION ON THE DISLOCATION OF TEMPOROMANDIBULAR JOINT (악관절탈구 환자의 임상 및 원인론적 고찰)

  • Kim, Jong-Won;Lee, Sang-Il;Lee, Jong-Heun
    • The Journal of the Korean dental association
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    • v.9 no.5
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    • pp.217-221
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    • 1971
  • Authors studied on the T.M.J. dislocation of 5 cases who were visit Dental College Infirmary, S.N.U. The results were obtained as follows. 1) The main symptoms are pain, cracking sound, discomfort of temporomandibular joint region and swelling. 2) All cases except only one case, no specific etiological factors were detected in related to habitual custom and hoby. 3) The patients are all female aged from 19 to 24 years old.

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Treatment of Atypical Facial Pain with Stellate Ganglion Block (비정형 안면통에서의 성상신경절 차단 치료)

  • Jeon, Young Hoon;Kim, Ji Hyun
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.3
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    • pp.173-175
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    • 2014
  • Atypical facial pain is loosely used term to describe some chronic facial pain when the symptoms do not exactly and entirely fit one diagnostic criteria. In many cases of pain disorders, sympathetic system is involved, such as in conditions which symptoms mimic post-herpetic neuralgia or complex regional pain syndrome. We report a case of a patient with atypical facial pain following the reduction of temporomanidbular joint dislocation. The atypical pain which was resistant to analgesic medication was successfully managed with stellate ganglion block. Therefore we suggest that stellate ganglion block can be an effective treatment method for controlling atypical facial pain.

Clinical and Radiologic Outcomes of Acute Acromioclavicular Joint Dislocation: Comparison of Kirschner's Wire Transfixation and Locking Hook Plate Fixation

  • Rhee, Yong Girl;Park, Jung Gwan;Cho, Nam Su;Song, Wook Jae
    • Clinics in Shoulder and Elbow
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    • v.17 no.4
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    • pp.159-165
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    • 2014
  • Background: Kirschner's wire (K-wire) transfixation and locking hook plate fixation techniques are widely used in the treatment of acute acromioclavicular joint (ACJ) dislocation. The purpose of this study was to compare the clinical and radiologic outcomes between K-wires transfixation and a locking hook plate fixation technique. Methods: Seventy-seven patients with acute ACJ dislocation managed with K-wire (56 shoulders) and locking hook plate (21 shoulders) were enrolled for this study. The mean follow-up period was 61 months. Results: At the last follow-up, the shoulder rating scale of the University of California at Los Angeles (UCLA) was higher in patients treated with locking hook plate than with K-wires ($33.2{\pm}2.7$ vs. $31.3{\pm}3.4$, p=0.009). In radiologic assessments, coracoclavicular distance (CCD) (7.9 mm vs. 7.7 mm, p=0.269) and acromioclavicular distance (ACD) (3.0 mm vs. 1.9 mm, p=0.082) were not statistically different from contralateral unaffected shoulder in locking hook plate fixation group, but acromioclavicular interval (ACI) was significant difference. However, there were significant differences in ACI, CCD, and ACD in K-wire fixation group (p<0.001). Eleven complications (20%) occurred in K-wire transfixation group and 2 subacromial erosions on computed tomography scan occurred in locking hook plate fixation group. Conclusions: ACJ stabilization was achieved in acute ACJ dislocations treated with K-wires or locking hook plates. Locking hook plate can provide higher UCLA shoulder score than K-wire and maintain CCD, and ACD without ligament reconstruction. K-wire transfixation technique resulted in a higher complication rate than locking hook plate.

Treatment for Tarsometatarsal Fracture-Dislocation (족근-중족 관절 골절 탈구의 치료경험)

  • Chung, Yung-Khee;Yoo, Jung-Han;Park, Yong-Wook;Noh, Dong-Geun;Ha, Sung-Han
    • Journal of Korean Foot and Ankle Society
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    • v.1 no.2
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    • pp.112-118
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    • 1997
  • Tarsometatarsal fracture-dislocation is uncommon but severe lesion. Since this lesion is sometimes difficult to recognize by roentgenography, it is easily overlooked. Three patients were treated with open reduction and internal fixation with 3.5 mm cannulated screw and K-wire, two had treatment with open reduction and internal fixation with 3.5 mm cannulated screw only and two had treatment with dosed reduction and short leg cast only between January 1994 and May 1996. The duration of follow-up ranged from twelve to twenty-nine months after the diagnosis. Results were assessed by a subjective questiormaire, physical examination, and radiographic analysis. Multiple fixation techniques for maintaining the reduction of tarsometatarsl joint have been introduced. We recent]y used the 3.5 mm cannulated screw for internal fixation of the tarso-first and second metatarsal fracture-dislocation. We think cannulated screw fixation has several advantages; 1. The cannulated screw fixation is more rigid than the K-wire fixation. 2. There is an decreased risk of screw breakage with early weight bearing. 3. It is possible to compress the involved joints, if necessary. There were no disability in all patients. One patient who was treated with delayed open reduction and internal fixation with 3.5 mm cannulated screw and K-wire had a radiographic mild degenerative arthritis. And one patient who was treated with dosed reduction and short leg cast had a mild metatarsus adductus. But. these two patients were symptom free. There was no correlation between the severity of the diastasis and the patient s functional result.

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The Surgical Treatment of Acromioclavicular Joint Dislocation using Modified Phemister and Modified Weaver-Dunn Operation (견봉쇄골 관절 탈구에서 Modified Phemister와 Modified Weaver-Dunn 술식을 이용한 수술적 치료)

  • Chun Churl-Hong;Lee Seong-Ho;Lee Byung-Chang;Cho Yong-Woo
    • Clinics in Shoulder and Elbow
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    • v.1 no.2
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    • pp.180-185
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    • 1998
  • There has been considerable controversy as to the treatment method of dislocation of the acromioclavicular joint, so various operative treatment modalities have been suggested. We analyzed the results of 40 patients with acromio­clavicular dislocation, in whom twenty patients were treated by modified Phemister method and 20 patients by modified Weaver-Dunn method above follow-up two years. The purpose of this study was to compare the clinical results of two operative methods. According to Weitzman criteriae for clinical results, 12 cases were excellent, six cases good and two cases fair in modified Phemister method. But in modified Weaver-Dunn method, ten cases were excellent, eight cases good, one case fair and one case poor. In radiological result, coracoclavicular distance was measured at preoperative, postoperative and last follow-up period. The modified Phemister method was 6.lmm, 1.5mm and 2.4mm respectively, and the modified Weaver-Dunn method 7.8mm, 2.lmm and 2.5mm respectively. The complications were two cases of heterotopic ossification, one case of inadequate fixation and one case of K-wire breakage in modified Phemister method, and two cases of early fixation loss and one case of heterotopic ossification in modified Weaver-Dunn method. We obtained that the clinical, functional and radiological results showed no significant difference in two methods. The modified Phemister method was effective treatment for old patients in acute injuries due to short operation time and simple technique. The modified Weaver-Dunn method, as a reconstructive operation that reduces various complications for young and active male patients, was also good for getting the stability of coraco­clavicular ligament through clavicular bony union.

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