• 제목/요약/키워드: tibial tuberosity

검색결과 32건 처리시간 0.021초

내측 무릎골 탈구를 나타낸 개에서 경골결절 전위술 후 대퇴사두근각의 변화 (Change of Quadriceps Angle after Tibial Tuberosity Transposition in Dogs with Medical Patellar Luxation)

  • 최성진;이기자;황의희;장세웅;정인성;김남수
    • 한국임상수의학회지
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    • 제31권4호
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    • pp.263-266
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    • 2014
  • 내측 무릎골 탈구를 나타낸 개에서 경골결절 전위술 실시후 대퇴사두근각(QA)의 변화를 평가하였다. 내측 무릎골 탈구를 나타낸 전체 62 증례 중 실험조건에 맞는 37개의 다리를 조사대상으로 선정하였다. 술전 QA는 각각 grade 2에서 $24.02{\pm}4.02^{\circ}$, grade 3에서 $26.08{\pm}5.66^{\circ}$ 그리고 grade 4에서 $30.25{\pm}7.41^{\circ}$로 나타났다. 술후 QA는 grade 2에서 $21.25{\pm}3.24$, grade 3에서 $19.16{\pm}3.92$ 그리고 grade 4에서 $19.72{\pm}7.30$로 나타났으며, 모든 등급에서 술후 QA는 술전 QA에 비해 유의성 있게 감소되었다(P < 0.05). 4개월간 추적관찰한 결과 모든 증례는 술후 양호한 예후를 나타냈었으나, 술후 QA는 정상보다 높게 나타났다. 이러한 결과는 정상범위보다 큰 술후 QA는 임상적 예후와 관련성이 적을 것으로 생각된다.

Influence of Plate Design on the Accuracy of Tibial Alignment after Center of Rotation of Angulation-Based Leveling Osteotomy in Toy-Breed Dogs

  • Han, Jae-Hong;Lee, Hae-Beom;Jeong, Jae-Min;Jeon, Young-Jin;Roh, Yoon-Ho
    • 한국임상수의학회지
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    • 제39권3호
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    • pp.100-106
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    • 2022
  • The center of rotation of angulation-based leveling osteotomy (CBLO) has been introduced for the stabilization of cranial cruciate ligament rupture (CCLR) in small-breed dogs. This technique can be applied to the tibia without damaging its tuberosity. Although different designs of CBLO plates are available, tibial plateau leveling osteotomy (TPLO) plates have been still used for stabilization during CBLO. To the best of our knowledge, no studies have reported the effects of TPLO plates on the postoperative limb alignment after CBLO. Therefore, the present study (January 2020 to February 2021) aimed to compare the postoperative outcomes (postoperative tibial plateau angle [TPA] and tibial alignment) in patients receiving CBLO and TPLO plates during CBLO. Paired stifle joints (n = 16) were obtained from eight toy-breed cadaver dogs (mean weight, 4.4 kg) that underwent CBLO. The joints were randomly assigned to receive the CBLO (CBLO group) or TPLO plates (TPLO group). Pre-and postoperative radiographs were obtained, and the dissected tibiae were evaluated. The following postoperative parameters were compared to evaluate the surgical outcome: TPA, osteotomy location, mechanical medial proximal tibia angle, inter-segment gap, and tibial plateau translation. No significant differences were found in the postoperative alignment between the two groups. Therefore, TPLO plates may be considered as a viable alternative in toy-breed dogs undergoing CBLO.

관절경을 이용한 오스굿씨 병(Osgood-Schlatter's Disease)의 골편 제거술 (Arthroscopic Removal of Ossicles Associated with Osgood-Schlatter's Disease)

  • 안진환;하권익;하철원;이석재
    • 대한관절경학회지
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    • 제4권1호
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    • pp.67-70
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    • 2000
  • 오스굿씨 병은 일반적으로 보존적 방법으로 치료하지만 이에 호전되지 않는 지속적 혹은 재발성 통증이 있는 경우 수술적 가료가 필요한 경우가 있다. 대부분의 저자들이 슬개건 원위 골부착 부위에 골편이 존재하는 경우에 이를 제거하는 것으로 좋은 결과를 얻을 수 있다고 보고해 왔다. 저자들은 경골결절 전면부에 절개를 가하여 슬개건을 박리 후 골편을 제거하는 기존의 방식대신 관절경을 이용하여 슬개건의 뒤쪽으로부터 골편에 접근하여 골편을 제거하는 수기를 보고하고자 한다. 관절경을 이용한 오스굿씨 병의 골편제거술은 슬개건에의 손상을 최소화 할 수 있고, 빠른 술후 회복을 기대할 수 있으며, 경골 결절 전방부에 절개를 가하지 않음으로써 절개창 치유 후에 잔존할 수 있는 무릎을 꿇을 때의 반흔부 불편감의 발생을 예방할 수 있고, 보다 미용적이라는 장점이 있는 술식으로 사료된다.

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추나 요법을 포함한 복합 한방치료를 이용한 오스굿-슐라터 병의 치료 증례보고 (A Case Report on Osgood-Schlatter Disease Treatment Using Complex Korean Medicine Therapy Including Chuna Therapy)

  • 이지원;고연석;주민수
    • 척추신경추나의학회지
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    • 제17권2호
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    • pp.51-62
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    • 2022
  • Objectives This case study aimed to investigate the effect of complex Korean medicine therapy and fascia Chuna therapy on Osgood-Schlatter disease. Methods Hospitalization treatment was performed on a 13-year-old Osgood-Schlatter patient who visited Woosuk University Korean Medicine Hospital. The patient complained of pain in both the tibial tuberosity and restriction on the range of knee joint movement. The results were evaluated using the visual analogue scale, knee injury and osteoarthritis outcome score, and range of motion. Results After treatment, knee pain decreased and range of movement angle improved. Conclusions This study suggests that complex Korean medicine therapy, including myofascial Chuna therapy, are effective in improving the range of motion and improving pain in early Osgood-Schlatter disease. The limitation of this study is that the subject of the study was limited to one case. Further clinical studies are required.

경골 근위부 골채취를 위한 내측 및 외측 접근법시의 삼차원적 길이계측 (THREE DIMENSIONAL LINEAR MEASUREMENT OF PROXIMAL TIBIA IN MEDIAL AND LATERAL APPROACH FOR BONE HARVESTING)

  • 남웅;박원서;정호걸;허경석;차인호
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제33권4호
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    • pp.307-311
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    • 2007
  • Purpose: The aim of this study was simply assessing linear measurements in the lateral and medial approach, respectively, for bone harvesting using anatomic and three-dimensional(3D) computed tomographic(CT) analyses on a dried cadaveric proximal tibia. In addition, the availability of the three-dimensional computed tomographic(3D-CT) analysis was also estimated. Materials and methods: Ten dried proximal tibia were obtained from five Korean cadavers. Four the reference points, the SM(superior-medial), IM(inferior-medial), SL(superior-lateral), and IL(inferior-lateral) were marked around the tibial tuberosity. The PM(posterior-medial) and PL(posterior-lateral) points were randomly marked at points farthest from the lateral and medial reference points, respectively, in the posterior border of the superior articular surface of both condyles. All measurements were obtained on the dried proximal tibia. After computed tomography had been performed, the three dimensional images were reconstructed using V works $4.0^{TM}$(Cybermed Inc., Seoul, Korea), and the length between the reference points were measured three dimensionally using the method described above. The error between the mean actual and mean 3D-CT measurements was calculated in order to determine the availability of the three dimensional computed tomographic analysis. Results: The length between the reference points was greatest at the IL-PM, which averaged $65.39mm{\pm}10.35$. This was followed by the SL-PM with $63.24mm{\pm}8.10$, the IM-PL with $58.09mm{\pm}10.02$, and the SM-PL with $51.99mm{\pm}9.06$. The differences between the IL-PM and SM-PL were 13.4 mm. The mean values were 55.04 mm in the medial approach and 64.32 mm in the lateral approach, and the differences between medial and lateral were 9.28 mm. The error between the mean actual and mean 3D-CT measurements was 0.31% and the standard deviation was 0.28%. Conclusion: The anatomical and three dimensional computed tomographic analysis indicates that there was only a 9.28 mm linear difference between the lateral and medial approach. This is consistent with previous studies, which showed that there was little difference between the two approaches in terms of the bone volume. In addition, the error(0.31%) and the standard deviation(0.28%) were considered low, demonstrating high accuracy of 3D-CT. Therefore it can be used in preoperative treatment planning.

무릎 방사선 검사 보조장비의 개발 (Development of Knee Radiography Auxiliary Device)

  • 이도병;배일환;김혜정;이소미;권덕문;최동호;김희준
    • 대한방사선기술학회지:방사선기술과학
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    • 제47권2호
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    • pp.87-95
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    • 2024
  • Most knee axial radiographs, known as sunrise and skyline view, were performed with the patient in the prone position. The authors tried to address some of the shortcomings of conventional radiography by developing a new radiography method, K-RAD. According to previous research, the K-RAD method showed a wider patellar-femoral joint space than conventional radiography and provided a clear patellar hemi-lateral image with a constant gap between the femoral trochlear groove and tibial tuberosity. The authors worked with an orthopedic specialist to perform radiography using the K-RAD method rather than using existing methods, and as a result, the two knees were aligned correctly and a clear image of the patellar-femoral joint space was created. The authors propose the K-RAD method for knee axial radiography because the K-RAD method provides a sense of stability to the patient and provides images with high diagnostic value.

족삼리 애구가 고혈압 환자의 혈압 강하에 미치는 영향 ; 무작위배정 임상연구 (Effect of Choksamni(족삼리, $ST_{36}$) Moxibustion on Blood Pressure Elevation in Hypertensive Patients: A Randomized Controlled Trial.)

  • 김보성;장인수;여진주;이태호;손동혁;서의석;강신화;곽민정;임영진
    • 대한한의학회지
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    • 제26권3호
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    • pp.66-73
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    • 2005
  • Objectives : The purpose uf this study was to evaluate the effect of Choksmni$(ST_{36})$ moxibustion in hypertensive patients who showed sudden elevation of blood pressure. Methods : Among patients admitted to Woosuk University Hospital from June to September 2004, sixty-one patients who had shown sudden elevation in systolic blood pressure over 100mmHg were chosen by random sampling and divided into a treatment group (Choksamni moxibustion group) and a control group. In the Choksamni $(ST_{36})$ moxibustion group, moxibustion was done at the point between tibial tuberosity and head of fibula where the $ST_{36}$ is known to be located. Direct moxibustion was practiced on the patients 5 times with an increase of size from a grain of rice to a bigger cluster. Male patients were chosen to practice on the left meridian and female patients were chosen to practice on the right meridian point. Changes in blood pressure after He moxibustion were checked 4 times at tine intervals of 30 minutes. In the control group, the patients took bed rest without my medical treatment. The two groups were compared in order to demonstrate whether then were any remarkable changes in depression of blood pressure. Results : There were significant decreases in the systolic and diastolic blood pressure before and after moxibustion. We found significant decreases in systolic blood pressure at 60 minutes, 90 minutes, and 120 minutes ana diastolic blood pressure at 120 minutes in the patient group compared with the control group. Conclusions : There was a statistically significant depressing effect on blood pressure elevation observed in the group with moxibustion at $ST_{36}$ versus the control group without any medical treatment.

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후족부 관상면 배열 영상에 대한 고안 (Introduction of Hindfoot Coronal Alignment View)

  • 문일봉;전주섭;윤강철;최남길;김승국
    • 대한방사선기술학회지:방사선기술과학
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    • 제29권4호
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    • pp.225-228
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    • 2006
  • 목 적: 후족부의 병리학적 상태의 치료와 평가를 위해서는 관상면에서 종골과 경골이 연관된 배열상태의 정확한 평가가 필수적이다. 이전의 방사선학적 검사인 발과 발목의 전후방향, 측방향, 사방향 촬영과 종골 축방향 촬영 등의 X-선 촬영상은 관상면에서 종골과 경골이 연관된 배열상태를 증명하지 못했다. 이에 본 연구에서는 후족부 관상면 배열영상(hindfoot coronal alignment view)을 새롭게 소개하고자 한다. 검사방법 : 1) 양쪽 발을 지탱할 수 있는 방사선투과성의 스탠드형 보조기구를 제작한다. 2) 양측 발은 weight-bearing position이 되게 한다. 3) 각각의 발의 위치는 발의 종축이 보조기구 판과 수직이 되도록 자세를 유지한다. 4) silhouette tracing: 발뒷꿈치 outline과 둘째 발가락이 일직선상으로 지나도록 위치시킨다. 5) 중심 X-선: 발바닥 쪽을 향해 약 $15{\sim}20^{\circ}의 각도로 종골의 뒷쪽을 향해 입사한다. 결 과 : 1) 경골 축과 종골의 내측, 외측 결절의 영상이 함께 표출된다. 2) 종골이 회전되지 않아야 한다. 3) 거퇴관절강(talotibial joint space)이 함께 나타나야 한다. 결 론: CT나 MRI 영상에서도 관상면에서 후족부의 배열상태를 증명할 수 있지만, 환자의 체중이 주어지지 않기 때문에 발의 임상적인 증상을 보여주기에는 충분하지 못했다. 하지만 후족부 관상면 배열영상은 후족부의 inversion, eversion의 자세변화를 보여주고, 경골 원위부와 종골의 varus, valgus deformity의 치료를 위한 평가 자료로 좋은 검사방법이며, 비교적 자연스럽고 편안한 자세로 환자에게 큰 도움을 줄 것으로 사료된다.

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Surgical Correction of Medial Patellar Luxation including Release of Vastus Medialis without Trochleoplasty in Small Breed Dogs: A Retrospective Review of 22 Cases

  • Choi, Hee-Bok;Kim, Sang-Yeoun;Han, Chang-Hoon;Jang, A-Ram;Jung, Hye-Jin;Hwang, Tae-Sung;Lee, Hee-Chun;Hwang, Yong-Hyun;Lee, Won-Jae;Lee, Sung-Lim;Lee, Jae-Hoon
    • 한국임상수의학회지
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    • 제35권3호
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    • pp.71-76
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    • 2018
  • In 22 dogs with medial patellar luxation (MPL) of grade 3 or lower, resection of the vastus medialis oblique muscle, patellar anti-rotational suture, fascia lata overlap, and tibial tuberosity transposition (TTT) were undertaken to stabilize the patella without trochleoplasty. Data including signalment, clinical symptoms, details of the affected hindlimb, preoperative and postoperative patellar luxation grades, postoperative recovery time, and postoperative complications were obtained from medical records. The grade of lameness was evaluated preoperatively and postoperatively. Mean (${\pm}SEM$) grade of medial patellar luxation was $2.64{\pm}0.11$ preoperatively and $0.2{\pm}0.27$ postoperatively. Mean (${\pm}SEM$) grade of lameness was $1.73{\pm}0.27$ preoperatively and $0.18{\pm}0.15$ postoperatively. Patellar reluxation occurred in 1 of 22 (4.5%) cases requiring additional surgery. At final follow-up, 2 of the 22 (9.0%) dogs, including one with reluxation, had occasional lameness. Client-based questionnaire results demonstrated significant improvements in all parameters. Surgical treatment of MPL that included resection of the vastus medialis oblique without femoral trochlear groove deepening improved surgical outcomes in dogs with up to grade 3 MPL.

이중 다발 자가 슬괵건을 이용한 전방십자인대 재건술 (Double-bundle Anterior Cruciate Ligament Reconstruction using Autogenous Hamstring Grafts)

  • 최남용;남원식;양영준;한창환;문찬웅;권재영;송현석
    • 대한관절경학회지
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    • 제12권2호
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    • pp.112-117
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    • 2008
  • 목적: 이중 다발을 이용한 전방십자인대 재건술은 등장성과 해부학적 기능을 회복할 수 있다는 장점이 있다. 본 연구는 전방십자인대 손상 환자에서 부가적인 전내측 입구를 통한, 자가 슬괵건을 이용한 이중 다발 재건술의 임상적 결과를 평가하고자 한다. 대상 및 방법: 2005년 1월부터 2006년 7월까지 자가 슬괵건(hamstring tendon)을 이용하여 이중 다발 전방십자인대 재건술을 시행한 60예(남자: 52예, 여자: 8예)를 대상으로 하였다. 평균 나이는 31.7세($20{\sim}51$세)였다. 평균 추시 기간은 13.4개월($12{\sim}16$개월)이었다. 슬관절의 경골 조면 부위에서 수평 사위(horizontal-oblique)의 피부 절개를 시행하여 반건양건(semitendinosus tendon)과 박건(gracilis tendon)을 얻었다. 후외측 다발을 위한 경골 터널은 해부학적인 위치에 만들었다. Yasuda 등이 보고한 방법을 변형하여, 후외측 다발을 위한 대퇴골 터널은 부가적인 전내측 입구를 통하여 만들었다. 전내측 다발에 대하여는 통상적인 방법으로 터널을 만들었다. 후외측 다발은 박건을, 전내측 다발은 반건양건을 사용하였다. 최종 추시시 관절 운동범위, 전방 전위 정도(KT-1000 관절계), pivot-shift 검사로 임상 결과를 평가하였다. 슬관절의 기능적 평가는 Lysholm score와 modified Feagin Scoring System를 측정하였다. 결과: 최종 추시시 관절 운동 범위 제한은 없었다. KT-1000 관절계를 이용한 정상측과의 비교에서 경골 전방 전위가 술전 평균 8.4 mm에서 술후 평균 1.7 mm로 향상되었다(p<0.05). Lysholm score는 술전 평균 64.1점에서 술후 평균 92.2점으로 향상되었다(p<0.05). Modified Feagin Scoring System에 의한 기능 평가에서는 90%에서 우수 이상의 결과를 보였다. 결론: 부가적인 전내측 입구를 통한, 자가 슬괵건을 이용한 이중 다발 전방십자인대 재건술은 우수한 임상 결과를 보였다.

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