• 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.

• Journal of the Korean Arthroscopy Society
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• v.8 no.2
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• pp.82-88
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• 2004

Purpose: In this study, we intended to ascertain the benefit of KT-2000 Knee arthrometer(KT-2000) in the diagnosis of ACL(Anterior cruciate ligament) injury by comparing the anterior displacement of normal knee with that of ACL deficient knee. Materials and Methods: We designated two examiners to measure the anterior displacement of the knee joint of 30 healthy individuals, using KT-2000, at 30$^{\circ}$ flexion setting of muscle full relaxation, contraction, 25$^{\circ}$ internal rotation and 25$^{\circ}$ external rotation and analyzed these results according to the variables and measured the preoperative anterior displacement of the ACL injured knee in the 30 patients who have gone through an arthroscopic ACL reconstruction later. Results: The results of examiner 1 are 6.5${\pm}$1.5 mm, 2.5${\pm}$0.9 mm, 4.8${\pm}$1.2 mm, 6.4${\pm}$1.3 mm in right knee and 5.6${\pm}$1.3 mm, 2.1${\pm}$0.8 mm, 4.5${\pm}$1.2 mm, 5.2${\pm}$1.3 mm in left knee, in order of muscle full relaxation, contraction, 25$^{\circ}$ internal rotation and 25$^{\circ}$ external rotation. The results of examiner 2 are 6.9${\pm}$1.2mm, 2.9${\pm}$1.1mm, 5.6${\pm}$1.6mm, 6.9${\pm}$1.5mm in right, 5.5${\pm}$1.7 mm,1.9${\pm}$0.9 mm, 5.1${\pm}$1.9 mm, 5.7${\pm}$1.6 mm in left knee, The side to side difference of examiner 1 in the setting of muscle relaxation is 0.9${\pm}$1.0 mm. The anterior displaement of ACL injured knee is average 11${\pm}$2.93 mm and difference of average 6.5${\pm}$2.31 mm form that of normal. In comparison between the right and left knees of healthy individuals, the both results of two examiners showed the statistical difference in the setting of muscle full relaxation but, the results showed the side to side difference below 2 mm in 25case(83%), 21case(70%) respectively and above 3 mm in just 1 case. In the comparison between the normal and ACL injured knees, the results show the statistical difference of the side to side difference in the setting of muscle relaxation(p<0.05). Conclusion: The KT-2000 result is affected by relaxation of muscles around knee, flexion angle of knee joint, rotation of tibia, the strength of displacing force, time of the test and physical factors as height and weight. However, the Accuracy of diagnosis of ACL injury by KT-2000 will increase if the examiner is skillful and the tests are made on the exact position of knee joint.

• PNF and Movement
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• v.15 no.1
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• pp.1-11
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• 2017

Purpose: The purpose of this study was to use an ICF tool in an intervention for anterior cruciate ligament reconstruction (ACLR) patients to examine and evaluate the patients' functional problems, measure the results of the intervention, and present the process of preparing proprioceptive neuromuscular facilitation (PNF) intervention strategies, thereby contributing to changes in and development of relevant future clinical practices. Methods: A PNF rehabilitation exercise program using an ICF tool was applied to ACLR patients five times per week for four weeks. To measure the resulting changes, the ICF evaluation display, the visual analog scale (VAS), the manual muscle test (MMT), the range of motion (ROM) test, the Lysholm knee score (LKS), and the muscle endurance test (MET) were used. Results: After the intervention was applied to the ACLR patients, improvements were achieved in all the tests: ICF evaluation display, VAS, MMT, ROM, LKS, and MET. Conclusion: Utilizing the ICF tool, this study identified functional problems of ACLR patients. When the intervention was applied, physical functions improved, and structural damage was reduced, leading to enhanced levels of functional activities such as postural changes, posture maintenance, gait, movements, and movements between different places. The patients were able to complete the teacher training, which was their goal.

• Journal of Oral Medicine and Pain
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• v.25 no.2
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• pp.223-228
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• 2000

The relationship between TMD and otologic symptoms such as tinnitus, vertigo and dizziness has been noted for many years. The existence of otologic symptoms in patients with TMD can be explained by the anatomic proximity and embryologic origin of the structures of the ear and the temporomandibular joint, however the pathogenesis of the symptoms is poorly understood. Serveral hypotheses have been proposed. : Eustachian tube hypothesis, the tensor tympani hypothesis, the otomandibular ligament hypothesis, excessive somatic concern hypothesis. Some investigators have reported that palpation of the deep masseter muscle, sternocleidomastoid muscle or clenching can intensify a patient's tinnitus and in that case, TMD therapy would improve their otologic symptoms. Although tinnitus and vertigo are common symptoms in the general population and also increase with increasing age, those are highly significantly associated with TMD compared with control group. This case report describes the possible mechanism and management of otologic symptoms in patient with TMD who has visited our clinic complaining asymmetric tinnitus and dull pain on her left masseter muscle.

• Journal of Korea Society of Industrial Information Systems
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• v.5 no.2
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• pp.1-8
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• 2000

Manual material handling(MMH)is major factor which causing physical injuries of worker at working area and frequency of low back pain(LBP) is increasing industrial accidents. Especially, working in bad circumstance such as farm, orchard, harbor loading and unloading, logging place and mining place which located in inclined slope can cause much possibility of hazard and absence of working balance can cause injuries of musculoskeletal system such as joint, bone, ligament. So, this study used EMG system to measure and evaluate muscle force information and fatigue of worker when lifting on slope. The result of measuring averaged integrated EMG(AEMG) shows multifidus muscle be used more than anything else in force. neck extensors are used at 15°, 20°frequently. generally the AEMG result shows multifidus muscle be used in force. Commonly, muscle fatigue of multifidus is higher than other muscle by analysis mean power frequency(MPF). The result of load sharing rate shows multifidus and erectorspinae which are deep spinal muscles is relatively high and neck extensor is low.

• Korean Journal of Applied Biomechanics
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• v.28 no.4
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• pp.199-205
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• 2018

Objective: The purpose of this study was to examine the effect of increase in barbell weight on closely related variable to the anterior cruciate ligament (ACL) injury which are knee joint kinematics, joint load, joint moment, and maximum load attainment point during snatch of the weight lifting. Method: The subjects of the study were 10 male Korean national weight lifting athletes (69 kg 5, 77 kg 5; age: $21.80{\pm}3.91yrs.$, height: $168.00{\pm}4.06cm$, weight: $75.00{\pm}4.02kg$, career: $7.8{\pm}3.99yrs.$, snatch records: $168{\pm}4.06kg$). The weight of the barbell during the snatch operation was set at 70%, 75% and 80% of the highest records for each subject studied. Results: The result obtained from the one-way repeated measure ANOVA are as follows: With increased barbell weight, the extension moment of the left knee joint was higher in the 80% condition than the 70% (p<.001). However, other variables were not statistically significant difference. According to the factor analysis of the variables related to maximum load attainment point of the ACL major injury variables, the first sub-factor was the internal shear force, the posterior shear force, the abduction moment, and the muscle activity of the VL. The second sub-factor was the extension moment of the knee joint, compressive force, adduction moment, and the third sub-factor was the muscle activity of BF. Conclusion: These results indicate that the possibility of ACL injury can be lowered when performing a stable snatch movement.

• International Journal of Automotive Technology
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• v.5 no.1
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• pp.33-46
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• 2004

A finite element model development of a 50th percentile male cervical spine is presented in this paper. The model consists of rigid, geometrically accurate vertebrae held together with deformable intervertibral disks, facet joints, and ligaments modeled as a series of nonlinear springs. These deformable structures were rigorously tuned, through failure, to mimic existing experimental data; first as functional unit characterizations at three cervical levels and then as a fully assembled c-spine using the experimental data from Duke University and other data in the NHTSA database. After obtaining satisfactory validation of the performance of the assembled ligamentous cervical spine against available experimental data, 22 cervical muscle pairs, representing the majority of the neck's musculature, were added to the model. Hill's muscle model was utilized to generate muscle forces within the assembled cervical model. The muscle activation level was assumed to be the same for all modeled muscles and the degree of activation was set to correctly predict available human volunteer experimental data from NBDL. The validated model is intended for use as a post processor of dummy measurement within the simulated injury monitor (SIMon) concept being developed by NHTSA where measured kinematics and kinetic data obtained from a dummy during a crash test will serve as the boundary conditions to "drive" the finite element model of the neck. The post-processor will then interrogate the model to determine whether any ligament have exceeded its known failure limit. The model will allow a direct assessment of potential injury, its degree and location thus eliminating the need for global correlates such as Nij.

• Clinics in Shoulder and Elbow
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• v.2 no.1
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• pp.8-13
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• 1999

The results of the operative treatment of the Grade III acromioclavicular joint injury is defined by the durability of the reduced joint and free of exertional pain. Several surgical techniques have been applied to reduce and stabilize the joints effectively. Resection of clavicular lateral end and subacromial decompression also could be applied to prevent post-operative arthritic change. Biomechanical studies reveals the role of clavicular elevation and rotation to achieve more than 90 degrees of elevation. It also serves as a attachment site of deltoid and trapezius muscle. The stability and mobility of the both acromioclavicular and coracoclavicular joint are important to get full functional recovery. We modified the methods of coracoacromial ligament transfer described by Weaver-Dunn and by Shoji et a!. to pre­vent pullout of the transferred ligament and to get more improved functional results. Main technical point was harvesting full thickness bone block and fix it through the key-hole to reduce pull out angle.

• The Journal of Korean Physical Therapy
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• v.19 no.6
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• pp.31-36
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• 2007

Purpose: This study compared the thigh circumference and Lysholm scale of a stable and unstable exercise group of patients who had undergone an anterior cruciate ligament reconstruction (ACL reconstruction). Methods: The subjects were patients more than 4 weeks after their ACL reconstruction and could stand on one leg. The patients were divided into a control group with 9 patients performing closed kinetic chain exercises on a stable floor and an experimental group with 10 patients performing closed kinetic chain exercises en an unstable floor. The degree of muscle atrophy was compared by measuring the circumference of the injured thigh before the exercise program, and 3 weeks and 6 weeks after the exercise program. The Lysholm scale was used to assess the function of the knee joint. Results: There was no significant increase in thigh circumference according to the exercise periods in the two groups. However, there was a statistically significant increase before exercises and 6 weeks after the exercises (p<0.05). There were statistically significant differences in the Lysholm scores between the two groups (p<0.05). Conclusion: There were no statistically significant increase in the two groups, but there was a significant difference between before the exercise program and 6 weeks after the exercise program (p<0.05).

• Korean Journal of Applied Biomechanics
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• v.17 no.3
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• pp.23-29
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• 2007

The purpose of this study were to investigate the differences between female and male basketball players in knee neuromuscular biomechanical factors during basketball rebound jump. Twelve high school female ($17.9{\pm}0.8years$) and twelve male ($19.0{\pm}1.6years$) basketball players rebound jumped for maximal vertical height to sufficiently stress the anterior cruciate ligament. Kinematic and ground reaction data were collected and combined with inverse dynamics to estimate the knee extensor and abductor torque. The EMG data from the biceps femoris and rectus femoris was used to estimate the ratio of quadriceps muscle activity. Female athletes showed more reduced knee flexion at foot contact, more increased knee abduction, extensor and abductor knee joint torque at foot contact, and quadriceps ratio at stance phase than those of male athletes. In conclusion, Female athletes showed differences in knee neuromuscular biomechanical factors than male athletes during basketball rebound jump.