• Journal of Korean Neurosurgical Society
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• 제65권3호
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• pp.361-369
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• 2022

Pediatric spine has growth potential with incomplete ossification, and also unique biomechanics which have important implications for trauma patients. This article intends to review various aspects of pediatric spine trauma including epidemiology, anatomy and biomechanics, and clinically relevant details of each type of injury based on the location and mechanism of injury. With the appropriate but not superfluous treatment, pediatric spine trauma patients can have better chance of recovery. Therefore, as a spine surgeon, understanding the general concept for each injury subtype together with the debate and progress in the field is inevitable.

• Advances in biomechanics and applications
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• 제1권3호
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• pp.143-158
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• 2014

Forearm fractures in children are very common among all pediatric fractures. However, biomechanical investigations on the pediatric forearm are rather scarce, partially due to the complex anatomy, closely situated, interrelated structures, highly dynamic movement patterns, and lack of appropriate tools. The purpose of this study is to develop a computational tool for child forearm investigation and characterize the mechanical responses of a backward fall using the computational model. A three-dimensional 10-year-old child forearm finite element (FE) model, which includes the ulna, radius, carpal bones, metacarpals, phalanges, cartilages and ligaments, was developed. The high-quality hexahedral FE meshes were created using a multi-block approach to ensure computational accuracy. The material properties of the FE model were obtained by scaling reported adult experimental data. The design of computational experiments was performed to investigate material sensitivity and the effects of relevant parameters in backward fall. Numerical results provided a spectrum of child forearm responses with various effective masses and forearm angles. In addition, a conceptual L-shape wrist guard design was simulated and found to be able to reduce child distal radius fracture.

• Korean Journal of Radiology
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• 제23권6호
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• pp.674-687
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• 2022

Patellofemoral instability (PFI) is common in pediatric knee injuries. PFI results from loss of balance in the dynamic relationship of the patella in the femoral trochlear groove. Patellar lateral dislocation, which is at the extreme of the PFI, results from medial stabilizer injury and leads to the patella hitting the lateral femoral condyle. Multiple contributing factors to PFI have been described, including anatomical variants and altered biomechanics. Femoral condyle dysplasia is a major risk factor for PFI. Medial stabilizer injury contributes to PFI by creating an imbalance in dynamic vectors of the patella. Increased Q angle, femoral anteversion, and lateral insertion of the patellar tendon are additional contributing factors that affect dynamic vectors on the patella. An imbalance in the dynamics results in patellofemoral malalignment, which can be recognized by the presence of patella alta, patellar lateral tilt, and lateral subluxation. Dynamic cross-sectional images are useful for in vivo tracking of the patella in patients with PFI. Therapeutic approaches aim to restore normal patellofemoral dynamics and prevent persistent PFI. In this article, the imaging findings of PFI, including risk factors and characteristic findings of acute lateral patellar dislocation, are reviewed. Non-surgical and surgical approaches to PFI in pediatric patients are discussed.

• 한국운동역학회지
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• 제21권3호
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• pp.361-368
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• 2011

The purpose of this study was to investigate the effect of isometric hip adduction and abduction on the muscle activities of vastus medialis oblique(VMO) and vastus lateralis(VL) during leg squat exercises. This study consisted of 21 healthy subjects who had no medical history of anterior knee pain or lower extremity disorders. The ball and belt were used to isometrically adduct and abduct the hip joint during the leg squat exercise, respectively. The surface electromyograms of VMO and VL were analyzed, and the findings were used to calculate the VMO:VL ratio during 3 different quadriceps-strengthening exercises(leg squat, LS leg squat with isometric hip adduction, LSHD leg squat with isometric hip abduction, LSHB). The muscle activities of VMO and VL and the VMO:VL ratios were compared using the paired t-test with Bonferroni adjustment. The results showed that the muscle activities of VMO and VL during LSHD were greater than those during LSHB. The VMO:VL ratio was the highest during LSHD. This finding suggests that LSHD using a ball is more effective than LS and LSHB in selectively increasing the muscle activities of VMO. Therefore, we suggest that leg squat exercise with isometric hip adduction using a ball would be useful for maintaining correct patella tracking and for selectively strengthening VMO.

• Journal of Korean Neurosurgical Society
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• 제61권6호
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• pp.661-668
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• 2018

Among the spinal disorders, the treatment approach for spinal deformities has been discussed least among department of neurosurgery. But nowadays, more and more neurosurgeons are interested in spinal deformities as well as complex spinal disorders and are doing not a few surgeries for these kinds of disease. Nevertheless, it is mandatory to understand the course of spinal deformity, principles of treatment, and surgical outcomes and complications. Understanding of the biology, biomechanics and metallurgy of the spine and instrumentation are also required for successful spinal deformity surgery. We need senior mentors and good surgical and neurophysiologic monitoring team. Knowledge of spinal deformity may be augmented with spine fellowships and surgical experience. Step by step training such as basic knowledge, orthopedic as well as neurosurgical disciplines and surgical skills would be mandatory. Neurosurgeons can have several advantages for spinal deformity surgeries. By high-level technical ability of the spinal cord handling to preserve neurological function and familiarity with microscopic surgery, better synergistic effect could be expected. A fundamental understanding of pediatric spinal deformity and growing spine should be needed for spinal deformity surgery.

• 한국콘텐츠학회논문지
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• 제9권11호
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• pp.231-239
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• 2009

본 연구는 생체역학 모델에 기반한 상지훈련을 통해서 강직성 사지마비(spastic quadriplegia) 아동의 균형능력과 상지기능의 변화를 알아보고자 하였다. 매 회기마다 앉은 자세 및 선 자세에서 기능적 팔 뻗기 검사를 실시하였고, 초기와 마지막 회기에 아동 균형척도(Pediatric Berg Balance Scale)와 3차원 동작분석 시스템(CMS-70P, Zebris Medizintechnik Gmbh, Germany)을 사용하여 움직임을 측정하였다. 1주간 기초선 측정 후, 4주간 매 40분씩 12회기 동안 생체역학적 모델에 기반한 상지훈련을 실시한 결과, 기능적 팔 뻗기 검사에서 모든 측정값이 기초선 평균의 +2SD(standard deviation)를 벗어났다. 동작 분석 시스템 상에서 수행 시간, 최고 속도, 최고 속도 도달 시간, 움직임 단위 수가 향상되었고, 아동 균형 척도 검사결과가 향상되었다. 따라서, 생체역학 모델에 기반한 상지훈련은 상지기능 향상뿐만 아니라 균형 향상에도 긍정적 도움이 될 것으로 사료되며, 연구 결과의 일반화를 위해서 대상자와 과제를 다양화한 추후 연구가 필요할 것이다.

• 대한정형외과학회지
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• 제55권5호
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• pp.444-449
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• 2020

전방십자인대 견열 골절은 주로 소아 및 청소년기에 발생하는 드문 손상으로 전방십자인대의 길이를 유지하여 정상적인 슬관절의 기능을 보존하기 위해서 견열 골편의 정복 및 고정이 필요하다. 이에 다양한 술기가 보고되었으나 성장판이 열려있는 소아에서의 성장판 손상의 위험으로 인해 치료 방법에 논란의 여지가 있다. 저자들은 성장판이 열려있는 소아의 전방십자인대 견열 골절에 봉합 나사못을 이용한 관절경적 교량형 봉합술을 시행하여 성장판의 손상 없이 견고한 고정 및 좋은 임상 결과를 얻어 이를 보고하고자 한다.