• Title/Summary/Keyword: joint injury

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Treatment of Rockwood Type III Acromioclavicular Joint Dislocation

  • Kim, Seong-Hun;Koh, Kyoung-Hwan
    • Clinics in Shoulder and Elbow
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    • v.21 no.1
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    • pp.48-55
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    • 2018
  • While non-operative treatment with structured rehabilitation tends to be the strategy of choice in the management of Rockwood type III acromioclavicular joint injury, some advocate surgical treatment to prevent persistent pain, disability, and prominence of the distal clavicle. There is no clear consensus regarding when the surgical treatment should be indicated, and successful clinical outcomes have been reported for non-operative treatment in more than 80% of type III acromioclavicular joint injuries. Furthermore, there is no gold standard procedure for operative treatment of type III acromioclavicular joint injury, and more than 60 different procedures have been used for this purpose in clinical practice. Among these surgical techniques, recently introduced arthroscopic-assisted procedures involving a coracoclavicular suspension device are minimally invasive and have been shown to achieve successful coracoclavicular reconstruction in 80% of patients with failed conservative treatment. Taken together, currently available data indicate that successful treatment can be expected with initial conservative treatment in more than 96% of type III acromioclavicular injuries, whereas minimally invasive surgical treatments can be considered for unstable type IIIB injuries, especially in young and active patients. Further studies are needed to clarify the optimal treatment approach in patients with higher functional needs, especially in high-level athletes.

Neglected Type IV Acromioclavicular Joint Injury - 2 Cases Report - (간과된 제 4형 견봉-쇄골 관절 손상 - 2례 보고 -)

  • Kim, Do-Young;Shin, Sung-Ryong;Yoo, Yon-Sik;Lee, Sang-Soo;Jeong, Un-Seob;Park, Keun-Min
    • Clinics in Shoulder and Elbow
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    • v.11 no.2
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    • pp.185-188
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    • 2008
  • Acromioclavicular joint injuries usually occur as a result of direct trauma to the superolateral aspect of the shoulder. Roockwood Type IV injuries are relatively uncommon, and they are easily misdiagnosed or neglected in patients who have suffered multiple traumas. Therefore, to correctly treat a patient with type IV injury, we need to take a careful physical examination and conduct proper radiologic evaluation for the acromioclavicular joint. We report here on two cases of modified Weaver-Dunn reconstruction for neglected type IV acromioclavicular joint injuries that were associated with multiple rib fractures.

Sports-related Overuse Injuries: Elbow joint (스포츠와 연관된 과사용 증후군: 주관절)

  • Oh, Jeong-Hwan;Keum, Jung-Sup;Park, Jin-Young
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.67-74
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    • 2008
  • Repetitive overhead throwing exerts significant mechanical stress on the elbow joint. Pitching in baseball, serving in tennis, spiking in volleyball, passing in American football and launching in javelin-throwing can all produce elbow pathology by forceful valgus stress, with medial stretching, lateral compression and posterior impingement. This stress can lead to developmental anatomic changes in the young thrower. Asymptomatic pathology in the shoulder and elbow joint is prevalent and, with overuse, can progress to disabling injury. Joint injury occurs as a result of the body's inability to properly coordinate motion segments during the pitching delivery, leading to further structural damage. The implications of acute and overuse injuries and the possibility of permanent damage should be understood by parents, coaches and the athletes. Proper understanding of the intrinsic and extrinsic risk factors that could lead to elbow injuries is thus required. Measures to prevent elbow injuries should include proper coaching, warm-up, medical expertise and protective gear. Injury prevention and rehabilitation should center on optimizing pitching mechanics, core strength, scapular control, and joint range of motion.

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Whole body hypoxic preconditioning-mediated multiorgan protection in db/db mice via nitric oxide-BDNF-GSK-3β-Nrf2 signaling pathway

  • Li, Yuefang;Huang, Yan;Cheng, Xi;He, Youjun;Hu, Xin
    • The Korean Journal of Physiology and Pharmacology
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    • v.25 no.4
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    • pp.281-296
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    • 2021
  • The beneficial effects of hypoxic preconditioning are abolished in the diabetes. The present study was designed to investigate the protective effects and mechanisms of repeated episodes of whole body hypoxic preconditioning (WBHP) in db/db mice. The protective effects of preconditioning were explored on diabetes-induced vascular dysfunction, cognitive impairment and ischemia-reperfusion (IR)-induced increase in myocardial injury. Sixteen-week old db/db (diabetic) and C57BL/6 (non-diabetic) mice were employed. There was a significant impairment in cognitive function (Morris Water Maze test), endothelial function (acetylcholine-induced relaxation in aortic rings) and a significant increase in IR-induced heart injury (Langendorff apparatus) in db/db mice. WBHP stimulus was given by exposing mice to four alternate cycles of low (8%) and normal air O2 for 10 min each. A single episode of WBHP failed to produce protection; however, two and three episodes of WBHP significantly produced beneficial effects on the heart, brain and blood vessels. There was a significant increase in the levels of brain-derived neurotrophic factor (BDNF) and nitric oxide (NO) in response to 3 episodes of WBHP. Moreover, pretreatment with the BDNF receptor, TrkB antagonist (ANA-12) and NO synthase inhibitor (L-NAME) attenuated the protective effects imparted by three episodes of WBHP. These pharmacological agents abolished WBHP-induced restoration of p-GSK-3β/GSK-3β ratio and Nrf2 levels in IR-subjected hearts. It is concluded that repeated episodes of WHBP attenuate cognitive impairment, vascular dysfunction and enhancement in IR-induced myocardial injury in diabetic mice be due to increase in NO and BDNF levels that may eventually activate GSK-3β and Nrf2 signaling pathway to confer protection.

A Case Report of Surgical Treatment in a Lamed Hunting Dog with Cranial Cruciate Ligament Rupture and Medial Meniscal Injury (사낭견에서 내측반월판 손상을 수반한 전방십자인대단열의 외과적 치유예)

  • 정순욱;김영대;박수현;정월순;이충헌;신영규
    • Journal of Veterinary Clinics
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    • v.16 no.2
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    • pp.497-500
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    • 1999
  • A 4 years old male mixed breed dog, which weighed 25.5 kg, referred to Veterinary Teaching Hospital at College of Veterinary Medicine in Chonnam National University, because of chronic hindleg lameness. Click sound by flexion and extension of stifle joint, positive reaction by cranial drawer movement, fat pad sign and tibial position in cranial drawer position on the lateral radiographic view, medial patellar luxation (grade II), and lameness score 2.5 at standing and 2 at walking in right hindleg were showed. Under general anesthesia with enflurane, after medial arthrotomy, it was performed to remove remnants of cranial cruciate ligament and torn medial menisci and joint closed. In modified retinacular imbrication technique, one lateral fabellar/tuberosity suture, one medial fabellar/tuberosity suture, and one imbrication suture adjacent to the patella were placed. At 9 days after operation, lameness score 0 was observed and general condition was excellent.

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Prediction of Maximal Flexion Strength for Exercise Intensity Setting and Measurement in Elbow Joint (팔꿉관절 운동강도 설정 및 측정을 위한 최대굴곡력 예측)

  • Jang, Jee-Hun;Kim, Jae-Min;Kim, Yeon-Kyu;Kim, Jin-Chul;Cho, Tae-Yong;Kim, Yun-Jeong;Lee, Sang-Sik
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.66 no.11
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    • pp.1628-1633
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    • 2017
  • The purpose of this study was to identify the difference and correlation in elbow joint maximal flexion strength according to measurement methods and characteristics of muscular contraction, and to develop the predictive equation of elbow joint maximal flexion strength for the optimal exercise intensity setting and accurate measurement. Subjects were 30 male university students. Elbow joint maximal flexion strength of isokinetic contraction, isometric contraction at $75^{\circ}$ elbow joint flexion position, isotonic concentric 1RM, manual muscle strength (MMT) were measured with isokinetic dynamometer, dumbbell, and manual muscle tester. Pearson's r, linear regression equation, and multiple regression equation between variables were calculated. As a result, the highest value was isometric contraction. The second highest value was MMT. The third highest value was isokinetic contraction. 1RM was the lowest. Predictive equations of elbow joint maximal flexion strength between isometric and isokinetic contraction, between isometric contraction and 1RM, among isometric contraction, 1RM, and body weight were developed. In conclusion, 1RM and isokinetic elbow joint maximal flexion strength could be seemed to underestimate the practical elbow joint maximal flexion strength. And it is suggested that the developed predictive equations in this study should be useful in criteria- and goal-setting for resistant exercise and sports rehabilitation after elbow joint injury.

Technical Note Transarticular Approach for Elbow Arthroscopy

  • Kim Sung-Jae;Jeong Jae-Hoon
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2004.11a
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    • pp.176-179
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    • 2004
  • Arthroscopy of the stiff elbow joint is a technically difficult procedure because of the decreased joint space of the elbow joint. even to experienced surgeons. Problems encountered include limited access of instrument to the intra-articular ,pace and an increased risk of cartilage injury in the contracted elbow joint. This study describes a novel transarticular approach for elbow arthroscopy that allow, the safe and effective creation of the proximal medial and lateral portals.

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Femoral Nerve Injury after Rectus Abdominis Muscle Slap Harvesting: A Case Report (복직근 유리피판 거상 후 합병된 대퇴 신경손상 1례)

  • Kim, Jino;Lew, Dae Hyun;Tark, Kwan Chul
    • Archives of Plastic Surgery
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    • v.33 no.4
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    • pp.510-513
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    • 2006
  • Purpose: The Rectus abdominis muscle free flap is utilized in various reconstruction surgeries due to easiness in harvesting, consistency of vascular pedicle and reduced donor site morbidity. But rarely, femoral nerve injury during rectus abdominis harvesting can be resulted. We report a case of femoral nerve injury after rectus muscle harvesting and discuss the injury mechanism with the follow-up process of this injury. Methods: To reconstruct the defect of middle cranial base after wide excision of cystic adenocarcinoma of the external ear, rectus muscle free flap was havested in usual manner. To achieve a long vessel, inferior epigastric artery was dissected to the dividing portion of femoral artery and cut. Results: One week after the surgery, the patient noted sensory decrease in the lower leg, weakness in muscle strength, and disabilities in extension of the knee joint resulting in immobilization. EMG and NCV results showed no response on stimulation of the femoral nerve of the left leg, due to the defects in femoral nerve superior to the inguinal ligament. With routine neurologic evaluations and physical therapy, on the 75th day after the operation, the patient showed improvement in pain, sensation and muscle strength, and was able to move with walking frame. In 6 months after the operation, recovery of the muscle strength of the knee joint was observed with normal flexion and extension movements. Conclusion: Rarely, during dissection of the inferior epigastric artery, injuries to the femoral nerve can be resulted, probably due to excessive traction or pressure from the blade of the traction device. Therefore, femoral nerve injury can be prevented by avoiding excessive traction during surgery.

Study on Injury Risk Factors of the Elderly for Safety·Security Design (안전·안심디자인을 위한 고령자의 손상 위험요인에 관한 연구)

  • Kim, Mi-Young
    • The Journal of the Korea Contents Association
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    • v.17 no.2
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    • pp.105-112
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    • 2017
  • This study recognizes it as a social problem that can be prevented by basic research on safety security design for the elderly, and aims to clearly analyze risk factors for injury. For this study, raw data from the 6th Korean National Health and Nutrition Survey were employed and analyzed. Their social characteristics were classified with standards including gender, education, EuroQoL(human locomotion, normal activity and pain uncomfortableness), the quality of life(PHQ-(1)(2)(4)), recognition on stress, activity restriction status and associated causes(bone fracture and joint injury). Their epidemiological traits were chronic diseases, 'diabetes and hip-joint pain', and health-behavioral traits were 'smoking, breakfast frequency and high-level physical activity status.' In conclusion, it can be found that damage risk of elderly rose in case of female, lower education, inconvenience or limitation, pain or discomfort in locomotion and daily activities, higher recognition of stress, lower interest in work, feeling of depression, despair, and weariness, restriction in activity caused by bone fracture and joint injury, having diabetes and hip-joint pain, smoking, low frequency in having breakfast and high-level physical activities. Based on this study, we envision that an effective solution for injury risk factors caused by the organic relation can be reached in the near future.

Arthroscopic Approach of the Elbow

  • Kim Seung-Ki
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2003.11a
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    • pp.61-63
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    • 2003
  • - Injury to the neurovascular structures can be minimized - Incising the skin only - Using blunt dissection and blunt trocars - Distending the joint - Placing the anterior portals in a more proximal position - With more innovation in instrument and techni

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