• Title/Summary/Keyword: orthopedic

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Mid to Long-term Outcome of Vascularized Pronator Quadratus-wrapped Radial Bone Flap Arthroplasty for Advanced $Kienb{\ddot{o}}ck's$ Disease (진행된 키엔벡 병에서의 방형회내근 유경 요골 피판을 이용한 관절성형술의 중장기 결과)

  • Gong, Hyun-Sik;Baek, Goo-Hyun;Lee, Young-Ho;Kim, Sae-Hoon;Cho, Young-Jae;Chung, Moon-Sang
    • Archives of Reconstructive Microsurgery
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    • v.15 no.2
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    • pp.101-106
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    • 2006
  • The purpose of this study was to analyze the mid to long-term clinical and radiological outcome of vascularized pronator quadratus-wrapped radial bone flap arthroplasty for symptomatic advanced $Kienb{\ddot{o}}ck's$ disease. Between 1982 and 2000, 41 cases of advanced $Kienb{\ddot{o}}ck's$ disease were treated with vascularized pronator quadratus wrapped radial bone flap arthroplasty. There were 17 men and 24 women, with a mean age of 39 years at the time of operation. According to Lichtman's classification, there were 13 stage IIIb and 28 stage IV patients. The duration of follow-up averaged 6.1 ($3{\sim}22$) years. We assessed the clinical outcome by subjective pain and active range of motion of the wrist, and evaluated the radiologic outcome by using carpal height ratio and radioscaphoid angle. Postoperatively, all patient reported an improvement in their symptoms. The mean active extension and flexion were improved by $9^{\circ}$ and $6^{\circ}$, respectively (p<0.05). The carpal height ratio was decreased from a mean of 0.52 to 0.48, and the radioscahpoid angle was increased from a mean of $61^{\circ}$ to $66^{\circ}$, but the differences were not significant statistically. Vascularized pronator quadratus-wrapped radial bone flap arthroplasty improves the wrist motion and may prevent serious carpal collapse in advanced $Kienb{\ddot{o}}ck's$ Disease.

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Arthroscopic Assisted Mini-open Repair of Rotator Cuff Tear - 5∼8 Years Follow-up Results - (관절경 보조 소절개 봉합술을 이용한 회전근 개 파열의 치료 - 5∼8년 추시 결과 -)

  • Kim Young-Mo;Rhee Kwang-Jin;Shin Hyun-Dae;Byun Ki-Yong;Kim Kyung-Cheon;Hong Ui-Pyo
    • Clinics in Shoulder and Elbow
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    • v.7 no.1
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    • pp.30-34
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    • 2004
  • Purpose: To report our experience of treatment of rotator cuff tear and evaluate the mid-term outcome. Materials and Methods: We have performed 50 cases of mini-open rotator cuff repair from March 1996 to March 1999. Male to female ratio was 34:16, the average age 46.5(23∼57) years old, mean follow-up period was 78(62∼93) months. All-arthroscopic repair and open repair cases were excluded. Mean symptomatic period was 12.5(6∼38) months, operation was indicated in cases of no improvement by 6 months of conservative management. Preoperative simple radiographs and Magnetic resonance arthrography were obtained in all cases. We also observed the inflammation, synovitis, thickness of tear and associated pathology intraoperatively. We evaluated pain, function, and range of motion by UCLA score. Results: Overall UCLA score was mean 29.5 points. Excellent 25, good 18, poor 7 cases. Mean pain score was improved 2.6 to 7.5, 44 cases(88%) were improved and 6 cases(12%) were not improved. Mean functional score was improved 3.4 to 8.5, and activity at follow up, 25 cases(50%) were same, 8 cases(14%) were above, 17 cases(34%) were below compared with preoperative level. Mean active forward flexion was preoperative 112° to postoperative 160°, forward flexion strength was improved 3.8 to 4.7. 43 cases(86%) of patients were satisfied at the result, 7 cases(14%) were not satisfied or aggravated. Results: Mini-open rotator cuff repair was effective method in treating rotator cuff tear.

Treatment of Iatrogenic First Metatarsal Dorsiflexion Deformity After Hallux Valgus Surgery -A Case Report- (무지 외반증 환자의 근위부 절골술 후 발생한 의인성 제 1 중족골의 족배 굴곡증의 치료 -1예 보고-)

  • Lee, Kyung-Tae;Young, Ki-Won;Kim, J-Young;Kim, Eung-Soo;Cha, Seung-Do;Son, Sang-Woo
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.199-203
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    • 2004
  • Purpose: We report a case that iatrogenic dorsiflexion deformity after hallux valgus surgery treated successfully with crescenteric plantar flexion metatarsal osteotomy. Materials and Methods: 43 years old female who suffered from left fore foot pain and deformity after hallux valgus surgery was evaluated. Results: Preoperatively she did not put on ordinary shoes and had had persistent pain and discomfort on 1st metatarsal area. She also had a callus on plantar surface of 2nd metatarsal head. Simple AP and Lateral x-ray identified that 1st metatarsal bone had a 23 degree dorsiflexion deformity. For correction of deformity, plantarflexion crescenteric osteotomy was performed on proximal 1st metatarsal area. After operation, All of symptom eliciting patient was gone and 43 points of AOFAS scale preoperatively improve 100 points and the patient very satisfied. Post operative x-ray was showing complete correction of deformity. Conclusion: As a treatment of iatrogenic dorsiflexion deformity after hallux valgus surgery, the crescenteric plantar flexion osteotomy can be good and safe modality for correction.

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Modified Brostrom Operation for Revision Lateral Ankle Ligament Reconstruction (실패한 만성 족근관절 외측 재건술에서의 변형 Brostrom 술식의 결과)

  • Lee, Kyung-Tai;Young, Ki-Won;Kim, J-Young;Kim, Eung-Soo;Cha, Seung-Do;Park, Shin-Yi
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.149-152
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    • 2004
  • Purpose: We assessed the clinical results of modified Brostrom procedure as a revision method after failure of a primary reconstruction. Materials and Methods: This is a retrospective study of seven patients treated with Modified Brostrom procedure after failed lateral ankle ligament reconstruction between 1996 and 2002. Instability symptom developed average 4.7 month after the initial reconstruction surgery at other clinics. All patients had significant functional impairment before surgery and not responded to conservative protocols. Modified Brostrom procedure was applied to all patients. Results: The average follow up was 51 months (18 to 84). Seven of eight patients had clinical stability following revision reconstruction, six patients (75%) returned to their previous functional level. American Orthopaedic Foot and Ankle Society ankle-hindfoot scores averaged 87.5. There is no difference in active or passive range of motion of plantar flexion or dorsiflexion when compared to the contralateral ankle. However, three patients were noted to have lost some degree of inversion when compated to contralateral ankle. Two patients had osteochondral lesion and multiple spurs and had pain around the ankle that prevented their full recovery. One patient complained of persistent pain which was considered complex regional pain syndrome. Conclusion: Though the outcome of the Modified Brostrom procedure as a method of revision surgery was less satisfactory compared to the results of primary ankle reconstruction, it would be an appropriate option when concomitant abnormalities were not accompanying.

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Arthroscopic Ankle Fusion Using Two Medial Cannulated Screws (2개의 내측 유관나사를 이용한 관절경하에서의 족근 관절 고정술)

  • Kim, Hak-Jun;Kim, Taik-Seon;Yoon, Jeong-Ro;Kim, Kyoung-Soo;Noh, Haeng-Kee;Yoon, Kwang-Sup
    • Journal of Korean Foot and Ankle Society
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    • v.8 no.2
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    • pp.171-175
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    • 2004
  • Purpose: We evaluated the clinical and radiological results of arthroscopic ankle fusion using 2 medial screws which had advantages of less morbidity, early weight-bearing and high union rate. Material and Methods: From April, 2002 to March, 2004, 8 patients who had ankle osteoarthritis were treated by ankle fusion using 2 medial screws under arthroscopy; five patients with post-traumatic osteoarthritis, two with post-infectious arthritis and one with paralytic foot. There were 5 male and 3 female. Average age was 67 years old ranging from 57 to 71 years. We evaluated them clinically preoperative and postoperative using AOFAS score, VAS pain scale and patient's satisfaction. In regard to radiological fusion, we checked them by simple AP, lateral and mortise view. Follow up period was average 11 months (range, $6{\sim}24$ months). Results: All ankles were successfully fused with 2 medial screws under arthroscopy. The mean time of fusion was 10.5 weeks (range, $8{\sim}14$ weeks). Patient's satisfaction checked at 6 months after operation had favorable results (excellent and good 75%). One case had pain on medial malleolar area because of screw's protrusion. Conclusion: Arthroscopic ankle fusion using 2 medial screws was good modality of ankle fusion with less morbidity and early weight-bearing in some cases of ankle arthritis.

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Isolated Anterior Dislocation of the Radial Head in Adult - A Case Report - (성인에서 발생된 요골 두 급성 전방 탈구 - 증례 보고 -)

  • Heo, Youn-Moo;Kim, Woo-Sik;Kim, Sung-Hun;Jeon, Teak-Soo;Kim, Sang-Bum;Oh, Byung-Hak
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.131-135
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    • 2007
  • We report an isolated anterior dislocation of the radial head in a 23-year-old man after a fall on the outstretched arm. At the time of the injury, the patient's elbow was in a position of mild flexion and pronation which was suddenly further pronated as he fell down. The radial head was incarcerated by the lateral portion of brachialis muscle, and annular ligament was interposed between capitellum and radial head. Open reduction was performed. During 12 months follow-up, reduction of radial head was well maintained without a limitation of range of motion.

An Anterior Approach to Entire Length of Humerus and to Distal Shaft for Fracture Fixation

  • Lee, Chul-Hyung;Choi, Hyun;Kim, Tae-In;Kim, Jun Beom;Shin, Sang Yeop;Rhee, Seung-Koo
    • Clinics in Shoulder and Elbow
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    • v.19 no.4
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    • pp.223-228
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    • 2016
  • Background: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. Methods: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). Results: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. Conclusions: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.

The Treatment of Tibial Shaft Fractures by Interlocking Nailing (Interlocking Nail을 사용한 경골간부 골절의 치료)

  • Lee, Jae-Chang;Lee, Jae-Sung;Ahn, Myun-Whan;Kim, Sae-Dong;Ihn, Joo-Chul
    • Journal of Yeungnam Medical Science
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    • v.5 no.1
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    • pp.61-67
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    • 1988
  • The treatment of tibial shaft fracture has become one of the most controversial subjects in orthopedic surgery. Comminuted, segmental and rotationally unstable fractures or bone defect at fracture site have problems of the fixation. The interlocking nail solve these problems. We have experienced 8 cases of the tibial shaft fractures treated with interlocking nail from 1986 to 1988. Authors analysed these cases and our own clinical study. The results were as follows. 1. The average bone union rate was about 15 weeks. 2. The interval between operation and crutch walking was 4:3 weeks. 3. The merits of this operation were the short hospitalization and early adaptation of social activity. 4. The advantage is be able to do early ambulation without following muscular atrophy or joint stiffness. 5. The results were assessed on clinical examination and radiographic appearance by Hamza et al. An excellent results were 7 cases and good result was 1 case.

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Superior Pole Sleeve Fracture of the Patella in Children - A Case Report - (소아에서 발생한 슬개골 상단부 소매형 골절 - 증례 보고 -)

  • Kim, Ki-Choul;Ahn, Gil-Yeong;Nam, Il-Hyun;Moon, Gi-Hyuk;Lee, Yeong-Hyun;Lee, Jae-Hoon
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.2
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    • pp.121-124
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    • 2009
  • Patellar fractures in children represent less than 2% of all patellar fractures including adults, and occur about 1% of all pediatric fractures. Because of property of the growing patella, osteochondral or avulsion fractures are more common in children and the most common type of patella fracture in children is sleeve fracture. Avulsion or sleeve fractures of the patella in children can occur at the superior or inferior pole of the patella. Most reported cases of sleeve fracture are involving the inferior patellar pole, but involving the superior patellar pole is very rare. We experienced a case of sleeve fracture occurred at the superior pole of the patella in a sixteen-year-old boy and report this case with literature review.

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Ultrasonographic Diagnosis of the Symptomatic Ganglion around the Bicipital Groove - Case Report - (증상을 유발한 이두구 주변의 결절종에 대한 초음파 진단 - 증례보고 -)

  • Han, Suk Ku;Kim, Seok Hyun;Song, Ha Jung;Kim, Ryul;Park, Hyun Woo;Song, Hyun Seok
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.8 no.1
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    • pp.21-25
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    • 2015
  • Diagnosis of the long head tendon of biceps is not easy. and an ultrasonography is helpful at the office. We report a case who visited with the right shoulder pain and was diagnosed as a mass around the bicipital groove using the ultrasonography, finally undertook an arthroscopic resection. On the histologic examination, synovial lining cell were not found, the wall was thickened. He diagnosed as ganglion.

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