• Title/Summary/Keyword: joint injury

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Subacute Osteomyelitis on Phalangeal Bone Resulting from Multiple Kirschner Pin Fixation: Case Report (원위지 골절에 K-강선을 이용한 비관혈적 정복술 후 생긴 아급성 골수염 1례)

  • Kim, Jae Woo;Choi, Hwan Jun;Kim, Mi Sun;Kim, Jun Hyuk
    • Archives of Plastic Surgery
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    • v.34 no.3
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    • pp.409-412
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    • 2007
  • Purpose: Percutaneous Kirschner wire fixation is common method for hand fracture. It is simple but has risk of ascending infection through the pin and bony injury by multiple drilling. Ascending infection through pin tract is mostly superficial and can be treated with antibiotics and aseptic dressing. This is a case review of subacute osteomyelitis on phalangeal bones after Kirschner wire fixation with literature review. Methods: A 40-years-old man with distal phalangeal fracture on right second finger is presented. He went to a local clinic and had percutaneous Kirschner wire fixation under local anesthesia. He was transferred to our hospital for ulcerative wound on DIP joint at 4 weeks after operation. Radiography showed osteolytic change around medulla of middle and distal phalanges, leading to diagnosis of a subacute osteomyelitis. We treated it with amputation at the level of shaft of middle phalanx. Results: The postoperative course was uneventful. We thought several possible reasons for osteomyelitis in our case. First, it could resulted from ascending infection through the wire. Second, it could be resulted from a bony burn by repeated drilling. And bony necrosis could be a consequence of arterial insufficiency caused by 2 pin insertion. Conclusion: We suggest that a precise pinning based on accurate anatomical understanding is required for a percutaneous Kirschner wire fixation. The frequency of drilling should be minimized. Careful observation and patient education for pin site care are essential.

Effects of Vertical Alignment of Leg on the Knee Trajectory and Pedal Force during Pedaling

  • Kim, Daehyeok;Seo, Jeongwoo;Yang, Seungtae;Kang, DongWon;Choi, Jinseung;Kim, Jinhyun;Tack, Gyerae
    • Korean Journal of Applied Biomechanics
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    • v.26 no.3
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    • pp.303-308
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    • 2016
  • Objective: This study evaluated the vertical and horizontal forces in the frontal plane acting on a pedal due to the vertical alignment of the lower limbs. Method: Seven male subjects (age: $25.3{\pm} 0.8years$, height: $175.4{\pm}4.7cm$, weight: $74.7{\pm}14.2kg$, foot size: $262.9{\pm}7.6mm$) participated in two 2-minute cycle pedaling tests, with the same load and cadence (60 revolutions per minute) across all subjects. The subject's saddle height was determined by the height when the knee was at $25^{\circ}$ flexion when the pedal crank was at the 6 o'clock position (knee angle method). The horizontal force acting on the pedal, vertical force acting on the pedal in the frontal plane, ratio of the two forces, and knee range of motion in the frontal plane were calculated for four pedaling phases (phase 1: $330{\sim}30^{\circ}$, phase 2: $30{\sim}150^{\circ}$, phase 3: $150{\sim}210^{\circ}$, phase 4: $210{\sim}330^{\circ}$) and the complete pedaling cycle. Results: The range of motion of the knee in the frontal plane was decreased, and the ratio of vertical force to horizontal force and overall pedal force in the complete cycle were increased after vertical alignment. Conclusion: The ratio of vertical force to horizontal force in the frontal plane may be used as an injury prevention index of the lower limb.

The Analysis of the Muscle Fatigue for the Lower Limbs Muscle during the Level and Downhill Running (평지와 내리막 달리기 시 하지 근육의 근 피로에 관한 연구)

  • Moon, Gon-Sung;Lee, Eui-Lin
    • Korean Journal of Applied Biomechanics
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    • v.17 no.4
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    • pp.181-190
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    • 2007
  • The purpose of this study was to analyze the muscle fatigue for lower limbs during the level and downhill running. The subjects were 6 males of twenties who have no experience to get the injury in the lower limbs and required to run on the level and downhill which was -7% grade treadmill at 8.3km/h. EMG signal was gained by ME3000P8 Measurement Unit and computed the Median Frequency(MF) with the power spectrum analysis in the Megawin software. Rectus femoris(RF), Vastus lateralis(VL), Gluteus medius(GLU), Biceps Femoris(BF), gastrocnemius medial head(GM), gastrocnemius lateral head(GL), Tibialis anterior(TA) were selected. The result of this study were as follows: The MF of RF decreased in the downhill running than level running in length of time but, the MF of VL was opposite. The MF of BF decreased in the level and downhill running, but, the MF of BF decreased much in the level than downhill running. The MF of GLU decreased much in the downhill running but, almost no change in the level running. The MF of TA decreased in the level running than downhill running. The MF of GL decreased in the level running but, the MF of GM decreased in the downhill running in length of time. This study analyzed the muscle fatigue of the lower limbs with the median frequency on the basis of an assumption that the impact force for the flexion and extension of the joint and the body mass may be much in the eccentric contraction such as the downhill running than level running. RF and GM showed the muscle fatigue in the downhill running than level running. BF and GL showed the muscle fatigue in the level running than downhill running.

A Case Report on the Meniscal Tear due to Repetitive Foot-Switch Stepping (반복적으로 풋스위치를 밟는 작업에 의한 반월상 연골 손상 증례)

  • Yu, Sun-Hee;Lim, Hyun-Sul;Kim, Doo-Hie;Chae, Dong-Ju;Kang, Suk
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.4 s.59
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    • pp.805-814
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    • 1997
  • Injuries to the menisci occur in a variety of ways, most commonly with a twist, pivot, squat, or valgus stress to the knee. Tear patterns are classified to longitudinal, horizontal, or transverse features according to the mechanism of injury. Work-related meniscal tear usually occurs with a repetitive usage of the foot, hence it can be classified as a cumulative traumatic disorder. We found a 47 year-old female worker who had been taking charge of repetitive foot-switch stepping for 8 years. She suffered from pain in the right knee since 5 months ago. Tenderness along the medial joint line of the right knee was observed and pain was aggravated with full flexion of the right knee. On magnetic resonance imaging, high signal intensity was observed at the posterior horn of the medial meniscus of the right knee. Degenerative longitudinal and transverse complex tear in the medial meniscus was observed on arthroscopy. Arthroscopic partial meniscectomy was performed. We surveyed the work process and the health status of co-workers. It turned out that the work process was compatible to injure the meniscus and nine out of fourteen co-worker(64.3%) complained pain of the knee. No other factors related to her meniscal tear could be found except for the situation at her work. Therefore, we conclude that meniscal tear is related to the repetitive stepping of foot switch.

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Proteomic Analysis of Differential Protein Expression in Fibroblast-like Synoviocytes of Pig

  • O, Baatartsogt.;So, Hyun-Kyung;Cho, In-Hee;Lee, Jeong-Soo;Lim, Hee-Kyung;Lee, Jong-Ha;Kim, Eun-Kuk;Choi, Kung-Duk
    • Proceedings of the Korean Society for Food Science of Animal Resources Conference
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    • 2006.05a
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    • pp.122-127
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    • 2006
  • The innermost structures of synovium consist of one to three layers of cells generally identified as synovial lining cells(SLC). The present studies were initiated to determine the protein expression patterns of fibroblast-like synovial(FLS) cells derived from the synovia of rheumatoid arthritis. Post-traumatic arthritis(PTA) is one of the most common causes of secondary osteoarthritis, and usually affects younger people. The proteins were separated by two-dimensional polyacrylamide gel electrophoresis and RNA expression investigated by RT-PCR Proteome analyses led to the identification of more than 1,500 protein spots and of 11 differently expressed protein spots among them. Six proteins were down-regulated, and five proteins were up-regulated in ACL-transected synovial tissue. Among these, spots 3 and 8 were identified as cofilin-1 and smooth muscle protein $22-\alpha$, respectively, Therefore, the proteome analysis of synovial tissue is a useful approach to investigate a joint after an injury and can be used to understand the pathogenesis of PTA.

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Analysis of the Shoulder and Elbow Section of the Korean Orthopedic In-training Examination

  • Kim, Joon Yub;Jung, Myung Gon;Kwon, Ki Bum;Chung, Seok Won
    • Clinics in Shoulder and Elbow
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    • v.19 no.2
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    • pp.67-72
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    • 2016
  • Background: The aim of this study was to analyze the questions in the shoulder and elbow section of the Korean Orthopaedic In-Training Examination (KOITE) and compare them with those of the US Orthopaedic In-Training Examination (US OITE). Methods: Twenty-nine questions in the shoulder and elbow section of the KOITE from 2010 to 2014 were analyzed and compared with those of the US OITE (80 questions) by literature review. A thorough analysis of the contents was performed after categorizing as topics, diagnostic tools, treatment modalities, taxonomic classification, and references. Results: The shoulder and elbow section of the KOITE was 5.8% weight which was similar to the US OITE (5.9%). The most commonly appearing topic was anterior labral injury (17.2%) on the KOITE compared to instability and arthritis (21.3%, each) on the US OITE. Magnetic resonance imaging was most frequently appeared imaging modality on the KOITE (41.0%) compared to the radiograph on the US OITE (43.0%). The Latarjet procedure was the most commonly asked treatment modality (22.2%) on the KOITE, whereas arthroplasty (33.3%) on the US OITE. The KOITE showed an even taxonomic classification distribution compared to the US OITE. Campbell's operative orthopaedics covered 96.6% questions as a reference on the KOITE compared to the Journal of Bone and Joint Surgery, American Volume on the US OITE, which covered 45.0%. Conclusions: This specific analysis shows us current trends of the shoulder and elbow section of the KOITE and it might be developed for use in the educational curricula for the trainee.

Effect of taping therapy on the pain and muscle activity of the back pain

  • Shin, Dong-min;Kim, Keun-Hee;Cho, Byung-Jun
    • Journal of the Korea Society of Computer and Information
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    • v.23 no.6
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    • pp.43-49
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    • 2018
  • In this paper, we propose a taping therapy as effective intervention for patients with the back pain. The purpose of this study is to investigate the effects of taping intervention on the VAS evaluated score and he muscular activation degree among 119 paramedics with musculoskeletal injury. In order to achieve the purpose of the study, data was collected from 15 paramediecs in the paramedics department of 3 fire stations under J city's fire defense headquarters. The following results can be obtained by measuring the subjective, the back muscle strength and the buckling-anteflexion before and after the taping for 15 119 paramedics. Through the verification experiment of taping effect to paramedics during the stretcher lifting in this study the VAS evaluated score for the backache are $1.67{\pm}0.62$ before and $0.80{\pm}0.68$ after the application of taping which show statistically significant decrease(p<0.05). In the experimentof joint operation range the measured buckling anteflexion length are $14.62cm{\pm}4.89$ before and $16.41cm{\pm}4.11cm$ after the application of taping which show statistically meaningful difference(p<0.05). In the comparison of muscle activity about paramedics erector spinae(ES) shows the meaningful decrease and external obliques(EO) displays the significant increase. Erector spinae(ES) and internal obliques(IO) show the increasing trend in the muscle activity although they are not significant. the muscle activity for the erector spinae is lowered so that the contribution to the force required for the extensor during the stretcher lifting is resultingly reduced to have the effects of enhancing the activity of abdominal muscles.

Schisandrae Fructus: A Potential Candidate Functional Food Against Muscle Atrophy and Osteoarthritis Prevention

  • Lee, Seung Young;Jin, Hyun Mi;Ryu, Byung-Gon;Jung, Ji Young;Kang, Hye Kyeong;Choi, Hee Won;Choi, Kyung Min;Jeong, Jin Woo
    • Proceedings of the Plant Resources Society of Korea Conference
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    • 2018.04a
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    • pp.8-8
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    • 2018
  • Muscle atrophy, known as a sarcopenia, is defined as a loss of muscle mass resulting from a reduction in muscle fiber area or density due to a decrease in muscle protein synthesis and an increase in protein breakdown. Many conditions are associated with muscle atrophy, such as aging, denervation, disuse, starvation, severe injury and inflammation, prolonged bed rest, glucocorticoid treatment, sepsis, cancer, and other cachectic diseases. On the other hand, osteoarthritis (OA) is the most common form of joint disease and is wide spread in the elderly population and is characterized by erosion of articular cartilage, osteophyte formation, and subchondral bone sclerosis. The cytokine network plays an important role in the development and progression of OA with the inflammatory cytokine. Schisandrae Fructus (SF) derived from the ripe fruit of Schisandra chinensis (Turcz.) Baill. (Magnoliaceae) has been extensively used in traditional herbal medicines in Asia. It was originally used as a tonic and has been traditionally used for the treatment of many uncomfortable symptoms, such as cough, dyspnea, dysentery, insomnia, and amnesia for a long time. Previous reports have shown that SF and its related compounds possess various biological activities such as antioxidant, anti-inflammatory, anticancer, anti-microbial, antiseptic, anti-aging, hepatoprotective and immunostimulating effects. However, the therapeutic effects of SF on muscle atrophy and OA has not yet been evaluated. In the present study, we aimed to determine whether extracts of SF, the dried fruit of S. chinensis, mitigates the development of muscle atrophy and OA.

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Limited internal fixation for the treatment of the Ovadia and Beals type II or III Pilon fracture (Ovadia와 Beals 제2형 또는 3형 경골 천정 골절의 제한적 내고정술을 이용한 치료)

  • Kim, Hyoung-Chun;Kim, Kwang-Yul;Lim, Mun-Sup;Kim, Jin-Hyoung;Kwon, Joon-Hyoung
    • Journal of Korean Foot and Ankle Society
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    • v.7 no.2
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    • pp.250-257
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    • 2003
  • Purpose: Pilon fracture is caused by high energy and axial compression forces, and it is often associated with severe comminution and soft tissue injury. Recently, limited internal fixation of this fracture may avoid the soft tissue complications associated with formal open reduction and internal fixation and avoid incongruity of joint margin associated with conservative treatment. We have treated Ovadia and Beals type II or III pilon fracture with limited internal fixation and the results were satisfactory. Materials and Methods: We analyzed 15 cases of Ovadia and Beals type II or III fractures who were treated by limited internal fixation(K-wire or screw fixation) from January 1995 to December 2000. The average follow up period was 20 months(range, 12 to 38 months). According to the Ovadia and Beals classification, seven cases were type II, and eight cases were type III. Radiographic results were assessed by Ovadia and Beals criteria. We also assessed the functional results by Mast and Teipner criteria. Results: Radiographic results showed good in 67% and fair in 33% of cases. Clinical results showed good in 73% and fair in 27% of cases. There were no complications such as wound infection and skin necrosis, but traumatic arthritis were 2 cases. Conclusion: Pilon fractures are high energy injuries with significantly associated soft tissue damage and traumatic arthritis. Limited internal fixation offers good solution to Ovadia and Beals type II or III fracture.

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Rotator Cuff Tears Syndrome (회전근개 파열 증후군)

  • Kang, Jeom-Deok;Kim, Hyun-Joo
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.13 no.1
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    • pp.67-72
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    • 2007
  • Anatomy: The rotator cuff comprises four muscles-the subscapularis, the supraspinatus, the infraspinatus and the teres minor-and their musculotendinous attachments. The subscapularis muscle is innervated by the subscapular nerve and originates on the scapula. It inserts on the lesser tuberosity of the humerus. The supraspinatus and infraspinatus are both innervated by the suprascapular nerve, originate in the scapula and insert on the greater tuberosity. The teres minor is innervated by the axillary nerve, originates on the scapula and inserts on the greater tuberosity. The subacromial space lies underneath the acromion, the coracoid process, the acromioclavicular joint and the coracoacromial ligament. A bursa in the subacromial space provides lubrication for the rotator cuff. Etiology: The space between the undersurface of the acromion and the superior aspect of the humeral head is called the impingement interval. This space is normally narrow and is maximally narrow when the arm is abducted. Any condition that further narrows this space can cause impingement. Impingement can result from extrinsic compression or from loss of competency of the rotator cuff. Syndrome: Neer divided impingement syndrome into three stages. Stage I involves edema and/or hemorrhage. This stage generally occurs in patients less than 25 years of age and is frequently associated with an overuse injury. Generally, at this stage the syndrome is reversible. Stage II is more advanced and tends to occur in patients 25 to 40 years of age. The pathologic changes that are now evident show fibrosis as well as irreversible tendon changes. Stage III generally occurs in patients over 50 years of age and frequently involves a tendon rupture or tear. Stage III is largely a process of attrition and the culmination of fibrosis and tendinosis that have been present for many years. Treatment: In patients with stage I impingement, conservative treatment is often sufficient. Conservative treatment involves resting and stopping the offending activity. It may also involve prolonged physical therapy. Sport and job modifications may be beneficial. Nonsteroidal anti - inflammatory drugs(NSAIDS) and ice treatments can relieve pain. Ice packs applied for 20 minutes three times a day may help. A sling is never used, because adhesive capsulitis can result from immobilization.

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