• Title/Summary/Keyword: joint dislocation

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

  • Kim, Hyun-jin;Joo, Yeong-chul;Choi, Jae-ho;Lim, Woo-taek
    • Journal of radiological science and technology
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    • v.42 no.6
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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.

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

  • Seo, Sun-Youl;Han, Man-Seok;Jeon, Min-Chul;Yu, Se-Jong;Kim, Yong-Kyun
    • Journal of radiological science and technology
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    • v.33 no.2
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    • pp.93-96
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    • 2010
  • This study evaluates usefulness of the developed assistant device by taking projection of patellofemoral joint in emergency patients who were doubt posterior cruciate ligament injury in knee joint. The subjects of experiment were patients who visited Eul-Ji University Hospital due to knee injury from January 2006 to December 2006. Seventeen patients, who took the Knee post stress view, Knee merchant view, Knee Seo's view to use assistant device and Knee MRI. To make assistant device of $170{\times}50{\times}70\;cm$, we evaluated its usefulness by measuring posterior dislocation of tibia. Seo's view is more accurate to make judgment of posterior cruciate ligament injury than original knee post stress view. Interval difference of posterior dislocation of original knee post stress view is $6.17{\pm}3.04$ and Seo's view is $8.74{\pm}4.47$. The results show injury of patellofemoral joint, vertical fracture of patella and posterior cruciate ligament injury by taking a projection using Seo's view. Therefore, it is useful to take projection earlier than talometer and MRI in emergency patients who were doubt posterior cruciate ligament injury in knee joint.

The Diagnosis of Rheumatologic and Degenerative Arthritis by X-ray Sacroiliac Joint Projection (X-ray 엉치엉덩관절 촬영법을 통한 류마티스 및 퇴행성관절염 진단)

  • Lee, Jun-Haeng
    • Journal of the Korean Society of Radiology
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    • v.12 no.3
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    • pp.397-402
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    • 2018
  • The study best image for diagnosis of fracture, dislocation and unilateral degenerative arthritis of the Sacroiliac joint, this study was performed to obtain the best image of the joint space of the hip joint by giving angle change to the pelvis phantom and the x-ray tube. I received evaluation. The results of the Receiver Operating Characteristic that in the case of simple photographs for the detection of joint arthritis and degenerative arthritis in the prone position, the photograph taken in the prone position raises the buttocks of the opposite side of the test by $25^{\circ}{\sim}30^{\circ}$ and the x-ray tube is perpendicular to the sagittal plane passing 2.5 cm inward from the thorny vertebra In the lying position, lift the Sacroiliac joint of the test side by $25^{\circ}{\sim}30^{\circ}$, and take a $5^{\circ}$ angle of the x-ray tube angle toward the foot toward the center of the upper bruch spine from it will be helpful to diagnose arthritis. the center of the upper bruch spine to the side of the ankle joints in the transverse direction And posterior direction, it will be helpful to diagnose arthritis.

Treatment of Temporomandibular Joint Reankylosis by Submandibular Anchorage Technique with Temporalis Myofascial Flap

  • Kim, Jun-Young;Kim, Jae-Young;Jung, Young-Soo;Nam, Woong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.36 no.2
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    • pp.78-83
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    • 2014
  • Management of temporomandibular joint (TMJ) ankylosis is challenging for the oral and maxillofacial surgeon because it involves the mouth opening, dentofacial deformity, diet problem, and quality of life. Although surgical techniques to treat TMJ ankylosis have improved, reankylosis is a persistent problem. The temporalis myofascial flap provides good material for interpositional arthroplasty, because of its good vascular supply, anatomic proximity, and adequate thickness. This case report examines the efficacy of submandibular anchorage to prevent reankylosis by inhibiting flap dislocation.

Ultrasound-guided intraoral botulinum toxin injection into the lateral pterygoid muscle for chronic temporomandibular joint dislocation

  • Sung-Tak Lee;Dohyoung Kim;Jae-Hyeong Park;Tae-Geon Kwon
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.1
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    • pp.41-48
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    • 2024
  • Objectives: Botulinum toxin type A (BTX), a powerful neurotoxin, can be an effective treatment choice for diverse muscular disorders and can reduce abnormal muscle activities. Abnormal movements of the mandible can be caused by involuntary and uncontrolled contractions of the lateral pterygoid muscle (LP) in various pathological situations. Previous reports have shown that BTX can reduce abnormal contractions of the LP. However, needle placement into the LP for BTX injection requires skill, experience, and sufficient anatomical knowledge. To place the needle precisely into the LP, ultrasonography (USG) can be used as an effective needle-guidance modality. USG is a non-invasive imaging modality able to create real-time images without any potential risks, including radiation exposure. Patients and Methods: The patients who had been performed USG-guided BTX injection into the LP using an intraoral approach were included in this study with a literature review and case presentations. Using the USG, four patients received BTX injections to treat recurrent temporomandibular dislocation and oromandibular dystonia resulting from involuntary LP activity. Result: Involuntary movements of the mandible were improved successfully in all patients, and showed satisfactory results without significant complication. Conclusion: The intraoral approach could prevent potential complications during needle placement. USG-guided BTX injection is an effective, convenient, and safe method that provides real-time imaging without unnecessary pain to the patient.

Anatomic reconstruction for acromioclavicular joint injuries: a pilot study of a cost-effective new technique

  • Pattu, Radhakrishnan;Chellamuthu, Girinivasan;Sellappan, Kumar;Kamalanathan, Chendrayan
    • Clinics in Shoulder and Elbow
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    • v.24 no.4
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    • pp.209-214
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    • 2021
  • Background: The treatment for acromioclavicular joint injuries (ACJI) ranges from a conservative approach to extensive surgical reconstruction, and the decision on how to manage these injuries depends on the grade of acromioclavicular (AC) joint separation, resources, and skill availability. After a thorough review of the literature, the researchers adopted a simple cost-effective technique of AC joint reconstruction for acute ACJI requiring surgery. Methods: This was a prospective single-center study conducted between April 2017 and April 2018. For patients with acute ACJI more than Rockwood grade 3, the researchers performed open coracoclavicular ligament reconstruction using synthetic sutures along with an Endobutton and a figure of 8 button plate. This was followed by AC ligament repair augmenting it with temporary percutaneous AC K-wires. Clinical outcomes were evaluated using the Constant Murley shoulder score. Results: Seventeen patients underwent surgery. The immediate postoperative radiograph showed an anatomical reduction of the AC joint dislocation in all patients. During follow-up, one patient developed subluxation but was asymptomatic. The mean follow-up period was 30 months (range, 24-35 months). The mean Constant score at 24 months was 95. No AC joint degeneration was noted in follow-up X-rays. The follow-up X-rays showed significant infra-clavicular calcification in 11 of the 17 patients, which was an evidence of a healed coracoclavicular ligament post-surgery. Conclusions: This study presents a simple cost-effective technique with a short learning curve for anatomic reconstruction of acute ACJI. The preliminary results have been very encouraging.

Anterior Dislocation of the Shoulder with Rotator Cuff tear Over the 5th Decades of Age (40대 이후 발생한 견관절 탈구와 회전근 개 파열)

  • Moon, Young-Lae;Lee, Sang-Hong;Kim, Jeoung-Ho
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.131-135
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    • 2002
  • Object : To evaluate the prognostic factors of the rotator cuff tear after anterior dislocation of the shoulder over the 5th decades of age. Methods : We evaluated twelve patients who had rotator cuff tears combined with primary anterior dislocation of the glenohumeral joint between May 1995 and October 1998. Their age were ranged from 42 to 67-years-old. Two of them were initially presumed to have an injury of the axillary nerve and associated with avulsion fracture of the greater tuberosity. Among twelve patients who had rotator cuff tears, 8 cases had massive, 3 cases had medium and one case had a small sized tear. Results : All the tears of the rotator cuff were repaired and the results were obtained by UCLA shoulder rating scale. Ten cases of them revealed more than good results except for 2 cases who had been unhappy triad of the shoulder injury. Conclusions : In the case of anterior dislocation of shoulder, it is necessary to check the injury of rotator cuff and axillary nerve in the middle age group. If these injuries are combined, proper rotator cuff repair and axillary nerve rehabilitation program would be asked for better results.

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Coracoclavicular Ligaments Reconstruction for Acromioclavicular Dislocation using Two Suture Anchors and Coracoacromial Ligament Transfer (견봉 쇄골 탈구의 봉합 나사못과 오구 견봉 인대 이전술을 이용한 오구 쇄골 인대 재건술)

  • Shin, Sang-Jin;Roh, Kwon-Jae;Jeong, Byoung-Jin
    • Clinics in Shoulder and Elbow
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    • v.11 no.1
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    • pp.46-52
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    • 2008
  • Purpose: This study examined the outcomes of reconstruction of the coracoclavicular ligaments with using two suture anchors and performing coracoacromial ligament transfer in patients with acromioclavicular dislocation. Material and methods: Forty patients with complete acromioclavicular dislocation were included in this study. According to the preoperative radiographs, 5 patients with AC dislocations were diagnosed as type III, 4 patients as type IV and 31 patients as type V. Two 3.5mm suture anchors with four strands of nonabsorbable sutures were separately placed on the anterolateral and posteromedial portion of the base of the coracoid process to stabilize the distal clavicle. The coracoacromial ligament was then transferred to the undersurface of the distal end of the clavicle for augmentation. Results: At a mean follow-up of 28 months, the average Constant score improved to 97 points. All the patients returned to normal life at an average of 3.2 months postoperatively. At the last follow-up, 37 patients achieved anatomical reduction and three patients showed complete redislocation. However, the clinical results of the patients with redislocation were satisfactory. Conclusion: Anatomical coracoclavicular reconstruction using two suture anchors and coracoacromial ligament transfer for treating complete acromioclavicular dislocation is a safe, effective procedure for restoring a physiologically stable acromioclavicular joint.

Arthroscopic Treatment of Acute Acromioclavicular Dislocation using $TightRope^{(R)}$ ($TightRope^{(R)}$를 이용한 관절경적 급성 견봉쇄골 관절 탈구의 치료)

  • Kim, In-Bo;Shon, Myung-Hwan;Kim, Moon-Chan;Kim, Dong-Jun
    • Journal of the Korean Arthroscopy Society
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    • v.15 no.1
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    • pp.13-18
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    • 2011
  • Purpose: The purpose of this study is to evaluate the radiologic and clinical results of the arthroscopic coracoclavicular fixation of the acute acromioclavicular dislocation using $TightRope^{(R)}$ (Arthrex, Inc, Naples, FL). Materials and Methods: We performed the arthroscopic coracoclavicular fixation using $TightRope^{(R)}$ in twenty patients with the Rockwood type III or V acute acromioclavicular dislocation between February, 2009, and February, 2010. Mean follow-up was 13.4(range 8~22) months. Radiologic results were evaluated by comparing the distances between the clavicle and the coracoid process with those in the contralateral sides using the acromioclavicular stress radiographs. Clinical results were made according to the KSS(Korean Shoulder Scoring System), and the cosmetic satisfaction of the patient was assessed. Results: Radiologically, 18 cases showed excellent, 1 case showed good and 1 case showed fair results. Clinically, KSS was mean 98.5 (range 92~100) points and all cases revealed satisfactory cosmetic results. Because one case complained of skin tenderness and discomfort of palpation, we closed the knot with surrounding muscle & fascia. Then local wound infection occurred, so we treated it by incision and drainage under local anesthesia and antibiotic therapy for 2 weeks. Conclusion: Arthroscopic coracoclavicular fixation using $TightRope^{(R)}$ for treating the Rockwood type III or V acute acromioclavicular dislocation showed satisfactory radiologic and clinical results. It seems to be a good treatment method that has little postoperative complication, provides an early rehabilitation and an excellent cosmetic result, and does not require secondary operation for removal of metal implant.

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A Rare Case of Irreducible Knee Dislocation: Vastus Medialis Obliqus-Buttonholing of Medial Femoral Condyle - A Case Report - (정복 불가능한 슬관절 탈구의 드문 예: 내측광근의 단추구멍손상 - 증례 보고 -)

  • Kim, Hyoung-Soo;Park, Seung-Rim;Kang, Joon-Soon;Lee, Woo-Hyeong;Kim, Ki-Wook
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.1
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    • pp.41-44
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    • 2001
  • The muscular button holing of vastus medialis is a very rare case of irreducible knee dislocations, and rapid reduction of this can diminish the complications which delayed reduction accompanies. We diagnosed a patient who appeared posterolateral dislocation of the knee and protrusion of the medial femoral condyle with MRI grossly. That was reduced by open arthrotomy, followed the reconstruction of both cruciate ligaments and repair of medial collateral ligament. Patient didn't show joint instability except minor posterior sagging and had full range of motion postoperatively after 10 months.

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