• 제목/요약/키워드: joint dislocation

검색결과 222건 처리시간 0.031초

악관절 융기 증강술을 통한 습관성 악관절 탈구환자의 치험례 (Surgical treatment of recurrent mandibular dislocation by augmentation of the articular eminence)

  • 김일규;신주호;오성섭;최진호;김형돈;오남식;김의성
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제22권2호
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    • pp.238-242
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    • 2000
  • Recurrent mandibular dislocation is frequent morbidity of temporomandibular joint relatively. There are many etiologic causes in TMJ disorders but, difficult to find obvious one. Various treatment methods have been utilized for a mandibular dislocation. It is categorized into two groups broadly - nonsurgical or surgical methods. The basic rationale of the surgical method is to allow free movement of the condyle by reducing height of articular eminence or to limit anterior excessive movement of the condyle by increasing height of articular eminence or soft tissue anchoring procedure. In this case, 69 year-old woman was treated by augmentation of the articular eminence with mandibular symphysial bone graft leading to osteosynthesis without difficulty. As a result, favorable postoperative outcome was obtained functionally without any complication or recurrence.

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Comminuted Radial Head Fracture in All-arthroscopic Repair of Elbow Fracture-dislocation: Is Partial Excision of the Radial Head an Acceptable Treatment Option?

  • Yang, Hee Seok;Kim, Jeong Woo;Lee, Sung Hyun;Yoo, Byung Min
    • Clinics in Shoulder and Elbow
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    • 제21권4호
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    • pp.234-239
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    • 2018
  • Background: In elbow fracture-dislocation, partial excision of the comminuted radial head fracture that is not amenable to fixation remains controversial considering the accompanying symptoms. This study was undertaken to evaluate the results of radial head partial excision when the comminuted radial head fracture involved <50% of the articular surface in all-arthroscopic repair of elbow fracture-dislocation. Methods: Patients were divided into two groups based on the condition of the radial head fracture. In Group A, the patients had a radial head comminuted fracture involving <50% of the articular surface, and underwent arthroscopic partial excision. Group B was the non-excision group comprising patients with stable and non-displacement fractures. Follow-up consultations were conducted at 6 weeks and at 3, 6, 12, and 24 months after surgery. Results: In all, 19 patients (Group A: 11; Group B: 8) met the inclusion criteria and were enrolled in the study. At the final follow-up, all 19 patients showed complete resolution of elbow instability. No significant differences were observed in the range of motion, visual analogue scale score, and Mayo elbow performance score between groups. Radiological findings did not show any complications of the radiocapitellar joint. However, nonunion of the coracoid fracture was observed in 3 patients (Group A: 1; Group B: 2), without any accompanying instability and clinical symptoms. Conclusions: Considering that the final outcome is coronoid fracture fixation and lateral collateral ligament complex repair for restoring elbow stability, arthroscopic partial excision for radial head comminuted fractures involving <50% of articular surface is an effective and acceptable treatment for elbow fracture-dislocation.

견봉 쇄골 관절 탈구의 관혈적 정복술시 오구 쇄골 인대 봉합의 필요성 (The Necessity of Coracoclavicular Ligament Repair in Open Reduction for the Acromioclavicular Joint Dislocations)

  • 김유진;신헌규;정화재;최재열;박세진;최규보;임종준
    • Clinics in Shoulder and Elbow
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    • 제13권2호
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    • pp.194-201
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    • 2010
  • 목적: 오구 쇄골 인대를 봉합하지 않고 견봉 쇄골 관절의 관혈적 정복만 시행한 환자군에서의 임상적, 방사선학적 추시 결과를 확인하고자 하였다. 대상 및 방법: 1998년부터 2007년까지 변형 Phemister 술식과 갈고리 금속판 (AO hook 금속판, Wolter 금속판)을 사용하여 견봉 쇄골 관절 탈구로 수술 받은 환자 중 삽입물 제거한 53예를 대상으로 하였다. 변형 Phemister 술식을 사용한 군이 21명, 갈고리 금속판을 사용한 군이 32명 이였다. 임상적 평가는 Constant score를 이용하였으며, 양측 쇄골과 오구돌기 사이의 수직 거리를 비교하여 방사선적 평가를 하였다. 결과: Constant score는 변형 Phemister 술식을 사용한 군에서는 $87.59{\pm}7.8$, 갈고리 금속판을 사용한 군에서는 $89.35{\pm}5.3$로 통계학적 차이는 없었다. 두 군에서 수술 전 손상 부위의 쇄골 오구돌기의 평균 거리는 15.9 mm이였으며, 건측 견관절은 평균 8.0 mm이였다. 갈고리 금속판 환자군에서 건측과 비교하여 평균 1.0 mm, 변형 Phemister 환자군에서는 평균 1.2 mm의 수직 전위가 관찰되었으며 통계학적 차이는 없었다. 결론: 오구쇄골 인대를 복원 하지 않은 견봉 쇄골 관절 탈구의 관혈적 정복술 및 내고정술은 양호한 임상적, 방사선학적 결과를 보였다.

관절내 종골 골절에서 종입방 관절 침범 분석 (Analysis of the Calcaneocuboid Joint Involvement in Intraarticular Calcaneal Fractures)

  • 신원주;양상훈;박홍기
    • 대한족부족관절학회지
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    • 제10권1호
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    • pp.42-47
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    • 2006
  • Purpose: This study was performed to analyze the characteristics of calcaneocuboid joint involvement in intraarticular calcaneal fractures. Materials and Methods: Total number of 92 patients (111 cases) who underwent operation for intraarticular calcaneal fractures between Jan. 2000 and Oct. 2005 were included in this study. The preoperative computed tomographs of the subjects were retrospectively reviewed to analyze calcaneocuboid joint involvement. Results: It was revealed that 63 cases (56.8%) involved calcaneocuboid joint; 29cases (46.0%) showed type 1 (undisplaced or minimally displaced type, articular gap ${\le}1\;mm$), 16 cases (25.4%) exhibited type 2 (moderately displaced type, articular gap ${\ge}2\;mm$), 7 cases (11.1%) were included in type 3 (comminuted type) and 11 cases (17.5%) belonged to type 4 (fracture and dislocation). 48 out of 63 cases belonged to Sanders classification II and III that involved calcaneocuboid joint and included 25 cases (52.1%) of type 1 and 14 cases (29.2%) of type 2. Among 15 out of 63 cases included in Sanders classification IV, 4 (26.7%) showed type 1 and 6 (40.0%) belonged to type 4. According to our results, Sanders classification allowed to predict pattern of the involvement of calcaneocuboid joint (P<0.05). However, there was no statistically significant relationship between degree of posterior facet joint injuries and calcaneocuboid joint involvement (P>0.05). Conclusion: Calcaneocuboid joint involvement in intraarticular calcaneal fractures was common and more than half showed severe injuries. We concluded that further studies on the involvement of calcaneocuboid joint should be performed prior to surgical treatment of intraarticular calcaneal fractures.

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Ultra-thin Rigid diagnostic and therapeutic arthroscopy during arthrocentesis: Development and preliminary clinical findings

  • Moon, Seong-Yong;Chung, Hoon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제37권
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    • pp.17.1-17.5
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    • 2015
  • Arthroscopy is useful to detect early changes in the temporomandibular joint (TMJ). Despite great advances in arthroscopy, many arthroscopic surgeries have now been replaced by arthrocentesis. We propose a simple diagnostic and therapeutic method having operative rigid ultra-thin arthroscopy with 16 gauge needle size combined with arthrocentesis.

슬대퇴관절의 Merchant View에서 중심 X선 위치에 따른 일치각 평가 (Assessment of Congruence Angle according to the Central X-ray in the Merchant View of Patellofemoral Joint)

  • 김현진;주영철;최재호;임우택
    • 대한방사선기술학회지:방사선기술과학
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    • 제42권6호
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    • pp.423-428
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    • 2019
  • The Precise measurement of the knee's Congruence angle is required for diagnosis of patella dislocation. The purpose of this study is to consider the distortion diagram and usefulness about the test of the bilateral side and one side through the evaluating congruence angle from Merchant view of patellofemoral joint to central X-ray. We've evaluated the sulcus angle and Congruence angle following central X-ray's changes when we took Merchant view of patellofemoral joint aimed to right lower limb from human whole body phantom. The subject of the evaluation was classified as normal group and varus group, and the varus group has experimented with External rotation of legs as 15° and 30°. When normal groups result as 0, 7.5, 15 cm, it was measured as 17.25 ± 1.34°, 19.60 ± 1.41°, 20.55 ± 1.77° each. The gap between minimal and maximum angle was 3.3°, and the value was shown as getting bigger when it further away from the centeral X-ray. When Congruence angle in 15° varus group was 0, 7.5, 15 cm, it was each 16.45 ± 1.34°, 17.10 ± 0.99°, 17.80 ± 1.13°. And when Congruence angle in 30° varus group was 0, 7.5, 15 cm, it was measured each 18.35 ± 1.63°, 18.95 ± 1.06°, 19.60 ± 1.41°. The difference between minimum and maximum of angle in 15° varus group and 30° varus group was each 1.35° and 1.25°, the angles have shown as increasing the further away from the center. The patellofemoral joint showed that the congruence angle increases as the further away from Central X-ray, and also it is judged that is possible to change the congruence angle by a degree of varus knee. Thus, accurate measurement of the congruence angle is shown to advantage that methods for examining by split each side at two times than methods for examining both sides at a time. Therefore, it is expected to helpful on the diagnostic side of patella dislocation and subluxation.

응급환자에서 후방십자인대 손상 및 슬대퇴 관절을 관찰하기 위한 보조기구 제작 및 유용성 평가 (The Evaluation of Usefulness New Assistant Device to Observe Posterior Cruciate Ligament Rupture and Patellofemoral Joint Injury in Emergency Patient)

  • 서선열;한만석;전민철;유세종;김용균
    • 대한방사선기술학회지:방사선기술과학
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    • 제33권2호
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    • pp.93-96
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    • 2010
  • 슬관절 후방십자인대 손상이 의심되는 응급환자의 슬대퇴 관절을 촬영하기 위한 보조기구를 제작하고 그 유용성을 평가하고자 하였다. 실험 방법은 2006년 1월부터 2006년 12월까지 슬관절 손상으로 을지대학병원에 내원한 환자 중 후방십자인대 손상 의증으로 Knee post stress view와 Knee Merchant view 그리고 보조기구를 이용한 Knee post stress view를 모두 촬영하고, 무릎 MRI(Knee MRI)검사를 시행한 17명을 대상으로 하였다. $170{\times}50{\times}70\;cm$의 보조 기구를 제작하였으며 Knee post stress view와 보조기구를 이용한 Knee Seo's view에서 경골의 후방전위 간격을 측정하여 유용성을 평가하였다. 그 결과 보조기구를 이용한 Knee Seo's view가 기존의 Knee post stress view에 비해 후방십자인대 손상 여부의 판단이 더 정확한 것으로 나타났다. 기존 촬영법의 경골 후방전위 간격 차이는 $6.17{\pm}3.04$이었으며, 보조기구를 이용한 촬영법의 경골 후방전위 간격 차이는 $8.74{\pm}4.47$이었다. 결론적으로 자체 제작 보조기구를 이용한 슬대퇴 관절 촬영법은 기존에 슬관절면 손상을 보기 위한 Knee Merchant view와 후방십자인대 손상을 보기 위한 Knee post stress view를 동시에 1회 촬영으로 끝낼 수 있었으며, 기존의 Knee post stress view 보다 후방십자인대 손상 여부를 보다 정확하게 알 수 있었다. 따라서 후방십자인대 및 슬대퇴 관절 손상이 의심되는 응급환자에서 talometer나 MRI 검사의 선행 검사로 유용하게 이용될 수 있을 것으로 사료된다.