• Archives of Reconstructive Microsurgery
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• 제16권2호
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• pp.93-99
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• 2007

Purpose: To report the clinical results and efficacies of one stage reverse lateral supramalleolar adipofascial flap for soft tissue reconstruction of the foot and ankle joint. Material and Methods: We performed 5 cases of one stage reverse lateral supramalleolar adipofascial flap from Jan 2005 to Sept 2005. All patients were males and mean age was 50(36~59) years old. The causes of soft tissue defects were 1 diabetic foot, 2 crushing injuries of the foot, 1 open fracture of the calcaneus, and 1 chronic osteomyelitis of the medial cuneiform bone. Average size of the flap was 3.6(3~4)${\times}$4.6(4~6) cm. All flaps were harvested as adipofascial flap and were performed with the split-thickness skin grafts (STSG) above the flaps simultaneously. Results: All flap survived completely and good taking of STSG on the flap was achieved in all cases. There were no venous congestion and marginal necrosis of the flap. In diabetic foot case, wound was healed at 4 weeks after surgery due to wound infection. There was no contracture on the grafted sites. Ankle and toe motion were not restricted at last follow up. All patients did not have difficulty in wearing shoes. Conclusion: The reverse lateral supramalleolar adipofascial flap and STSG offers a valuable option for repair of exposure of the tendon and bone around the ankle and foot. Also one stage procedure with STSG can give more advantages than second stage with FTSG, such as good and fast take-up, early ambulation and physical therapy, and good functional result.

• Clinics in Shoulder and Elbow
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• 제8권2호
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• pp.127-130
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• 2005

We describe a secure and easy-to-tie knot with a lag bight, the SP knot. An optimal sliding knot is required to be a low-profile, easy to throw, slide well, and provide a good initial security. The SP knot easily slides and sets while avoiding premature locking during sliding. While maintaining tension on the post limb with a knot pusher, pulling the loop limb makes it to flip and distort post limb, resulting in creation of a snug knot on the exact location with desired tension. The SP knot has one knot configuration before pulling the loop limb, but it converts to two knots after pulling the loop limb, one half-hitch and one 'clove hitch', which could provide enough loop security before any additional half-hitches. The configuration of the completed SP knot is formed lying along the loop of the knot, rather than stacking up, which enables a very low profile. The SP knot has various characteristics of the optimal arthroscopic slip knot and may be a useful tool for successful arthroscopic surgery.

• Clinics in Shoulder and Elbow
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• 제8권2호
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• pp.122-126
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• 2005

Purpose: To assess the long-term effect of ulnohumeral arthroplasty and the relationship between radiological recurrence and clinical outcome. Materials and Methods: Eleven elbows with primary osteoarthritis were analyzed at an average of eighty months after ulnohumeral arthroplasty. All patients were male with a mean age of fifty years. The outcomes were assessed using the Mayo Elbow Performance Score(MEPS) and the clinical and radiological results were compared. Results: Four elbows were not painful and six were mildly painful but one was not changed. The mean gain in extension was $15^{\circ}$, in flexion $10^{\circ}$. There were satisfactory results in 8 elbows(73%) and the mean MEPS was 81 points. All of eleven elbows had some degree of recurrent osteoarthritis and there was no correlation between radiological recurrence and clinical endpoints in nine elbows. But in two elbows, it appeared that recurrence of osteophyte at coronoid process was severe and caused fair outcome. Conclusion: Ulnohumeral arthroplasy is one of the effective treatment options for primary osteoarthritis of the elbow. The radiological recurrence did not correlated with the clinical outcome in most cases.

• Clinics in Shoulder and Elbow
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• 제19권3호
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• pp.155-162
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• 2016

Background: The study aimed to determine the type of capsular insertion and the extent of capsular elongation in anterior shoulder instability by quantitatively evaluating their computed tomography arthrographic (CTA) findings, and to investigate the correlation of these parameters with surgical outcomes. Methods: We retrospectively reviewed 71 patients who underwent CTA and arthroscopic capsulolabral reconstruction for anterior shoulder instability between April 2004 and August 2008. The control group comprised 72 patients diagnosed as isolated type II superior labrum anterior to posterior (SLAP) lesion during the period. Among the 143 patients, 71 were examined with follow-up CTA at an average 13.8 months after surgery. It was measured the capsular length and cross-sectional area at two distinct capsular regions: the 4 and 5 o'clock position of the capsule. Results: With regards to the incidence of the type of anterior capsular insertion, type I was more common in the control group, whereas type III more common than in the instability group. Anterior capsular length and cross-sectional area were significantly greater in the instability group than in the control group. Among patients of the instability group, the number of dislocations and the presence of anterior labroligamentous periosteal sleeve avulsion lesion were significantly associated with anterior capsular redundancy. Postoperatively, recurrence was found in 3 patients (4.2%) and their postoperative capsular length and cross-sectional area were greater than those of patients without recurrence. Conclusions: Capsular insertion type and capsular redundancy derived through CTA may serve as important parameters for the management of anterior shoulder instability.

• Clinics in Shoulder and Elbow
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• 제23권3호
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• pp.119-124
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• 2020

Background: This study was performed to compare glenoid version and inclination measured using two-dimensional (2D) images from computed tomography (CT) scans or three-dimensional (3D) reconstructed bone models. Methods: Thirty patients who had undergone conventional CT scans were included. Two orthopedic surgeons measured glenoid version and inclination three times on 2D images from CT scans (2D measurement), and two other orthopedic surgeons performed the same measurements using 3D reconstructed bone models (3D measurement). The 3D-reconstructed bone models were acquired and measured with Mimics and 3-Matics (Materialise). Results: Mean glenoid version and inclination in 2D measurements were -1.705° and 9.08°, respectively, while those in 3D measurements were 2.635° and 7.23°. The intra-observer reliability in 2D measurements was 0.605 and 0.698, respectively, while that in 3D measurements was 0.883 and 0.892. The inter-observer reliability in 2D measurements was 0.456 and 0.374, respectively, while that in 3D measurements was 0.853 and 0.845. Conclusions: The difference between 2D and 3D measurements is not due to differences in image data but to the use of different tools. However, more consistent results were obtained in 3D measurement. Therefore, 3D measurement can be a good alternative for measuring glenoid version and inclination.

• Clinics in Shoulder and Elbow
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• 제23권3호
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• pp.125-130
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• 2020

Background: To determine the prevalence of rotator cuff diseases in a population older than 40 years in or nearby Chuncheon city, Republic of Korea. Methods: Sixty shoulders of 30 people older than 40 years who participated in a health lecture were examined for free by an orthopedic surgeon. Visual analog scale of pain and American Shoulder and Elbow Surgeons scores were assigned, and routine physical examination was performed. Ultrasonography was performed on the shoulder. Results: On ultrasonographic examination, there were one shoulder with full thickness rotator cuff tear, 20 of 60 (33%) with partial thickness rotator cuff tear, five of 60 (8%) with calcific tendinitis, one of 60 (2%) with tear of the long head of the biceps, and five of 60 (8%) with tendinitis of the long head of the biceps. Participants older than 60 years showed significantly high proportions of lesion of the long head of the biceps and rotator cuff diseases (P=0.019 and P=0.015, respectively). Participants who performed physical labor had high proportions of rotator cuff tear and rotator cuff disease (P=0.001 and P<0.001, respectively). Conclusions: Rotator cuff diseases showed a high prevalence in aged persons and resulted in a decrease in shoulder function.

• 대한골관절종양학회지
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• 제4권2호
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• pp.81-87
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• 1998

Although autoclaved autogenous bone reconstruction is one of the established procedures, it may have some problems in bone regeneration and mechanical property. The purpose of this study is to evaluate the efficacy of more biologic and anatomical reconstruction where allograft is not readily available. From Aug.1991 to Feb. 1996 the authors analyzed 32 cases of reconstruction with autogenous low heat treated bone. Autogenous graft sites were humerus 4, tibia 4, pelvis 9, and 15 femur. Average follow-up period was 23(range;12-51) months. There were 49 graft-host junctional sites. Diaphysis was 22, metaphysis 10, and flat bone 17. Average duration of healing for the 38 united sites was 7 months. Average union time for each anatomical area 8 months in 19 diaphysis, 12 months in 7 metaphysis, and 12.7 months in 12 flat bone(pelvis). Eleven nonunion sites consisted of 3 diaphysis(3/22), 3 metaphysis(3/10), and 5 flat bone(5/17). Complications other than nonunion were local recurrence(4), bone resorption(3), graft fracture(2), osteomyelitis(1), metal failure(2), and wound infection(1). Initial bone quality and stable fixation technique was important for union rate. Plate and screw is a good method for diaphyseal lesion. Metaphyseal and flat bone are weak area for rigid fixation and one stage augmentation with iliac bone graft can be a salvage procedure.

• Molecules and Cells
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• 제38권11호
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• pp.941-949
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• 2015

Rheumatoid arthritis is a chronic inflammatory disease that leads to bone and cartilage erosion. The inhibition of osteoblast differentiation by the inflammatory factor TNF-${\alpha}$ is critical for the pathogenesis of rheumatoid arthritis. To modulate TNF-${\alpha}$ mediated inhibition of osteoblast differentiation is required to improve therapeutic efficacy of rheumatoid arthritis. Here, we explored the potential role of rocaglamide-A, a component of Aglaia plant, in osteoblast differentiation. Rocaglamide-A prevented TNF-${\alpha}$ mediated inhibition of osteoblast differentiation, and promoted osteoblast differentiation directly, in both C2C12 and primary mesenchymal stromal cells. Mechanistically, Rocaglamide-A inhibited the phosphorylation of NF-${\kappa}B$ component p65 protein and the accumulation of p65 in nucleus, which resulted in the diminished NF-${\kappa}B$ responsible transcriptional activity. Oppositely, overexpression of p65 reversed rocaglamide-A's protective effects on osteoblast differentiation. Collectively, rocaglamide-A protected and stimulated osteoblast differentiation via blocking NF-${\kappa}B$ pathway. It suggests that rocaglamide-A may be a good candidate to develop as therapeutic drug for rheumatoid arthritis associated bone loss diseases.

• 대한정형외과스포츠의학회지
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• 제10권1호
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• pp.41-45
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• 2011

반월상 연골판의 뿌리파열의 심각성이 인식되면서 이에 대한 적극적인 봉합이 필요하게 되었다. 특히 후각부 뿌리 파열에 대한 봉합 방법과 결과가 최근에 많이 보고되고 있다. 그러나 전각부 뿌리 파열에 대한보고는 아직 보고된 바 없으며 이에 저자들은 과거에 시행했던 원판형 연골의 부분 절제 후 발생한 의인성 뿌리 파열과 이로 인한 아탈구를 경험하였고 이를 봉합나사를 이용하여 정복하여 좋은 결과를 얻었기에 보고하는 바이다.

• 대한정형외과 초음파학회지
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• 제3권2호
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• pp.79-83
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• 2010

근골격계 초음파는 오랜 기간 동안 다양한 정형외과적 질환의 진단을 위해 유용하고 간단한 방법으로 사용되어 왔다. 일반적으로 MRI가 해부학적 구조나 변이를 발견하기 위한 가장 좋은 방법으로 알려져 있으나 건이나 신경의 탈구 또는 아탈구 등과 같은 동적인 조건의 경우에는 초음파, 특히 동적 초음파의 유용성에는 미치지 못하는 것으로 알려져 있다. 본원에서는 주관 증후군 유사 증상을 보인 환자에서 동적 초음파 검사를 이용하여 척골 신경 아탈구를 확인한 후, 척골 신경 이전술을 시행하여 만족스러운 결과를 보여, 주관 증후군과 유사한 증상을 유발하는 척골 신경 아탈구 환자에게 동적 초음파의 이용은 매우 유용한 방법으로 생각하여 그 증례를 보고하고자 한다.