Background: The goal of this study was to evaluate whether a modified fluoroscopic technique for positioning a hook plate affected the clinical results of treating Neer type II distal clavicle fractures and Rockwood type V acromioclavicular (AC) joint separations with this device. Methods: The study was a retrospective consecutive case series with data analysis. Sixty-four patients with a Neer type II distal clavicle fracture or a Rockwood type V AC joint injury treated between March 2009 and June 2013 were divided into 2 groups: traditional fluoroscopic technique (traditional view, 31 patients) or modified fluoroscopic technique ('hook' view, 33 patients). A visual analogue scale (VAS) score, the modified University of California-Los Angeles (UCLA) shoulder scale score, and radiographic osteolysis were the main outcome measures. Results: The traditional group included a significantly larger number of patients with acromial osteolysis than the hook view group: 23 patients (74.2%) vs. 11 patients (33.3%), respectively (p=0.01). Before plate removal, the hook group reported less pain and higher UCLA shoulder scale scores than the traditional group: average VAS score, 1.55 vs. 2.26, respectively; average UCLA score, 30.88 vs. 27.06, respectively. However, there was no significant difference after plate removal. Conclusions: The hook view allows more accurate bending of the hook plate around the contour of the acromion, resulting in decreased osteolysis, decreased pain, and better function with the plate in situ.
Objective : A thoracolumbar burst fracture is usually unstable and can cause neurological deficits and angular deformity. Patients with unstable thoracolumbar burst fracture usually need surgery for decompression of the spinal canal, correction of the angular deformity, and stabilization of the spinal column. We compared two struts, titanium mesh cages (TMCs) and expandable cages. Methods : 33 patients, who underwent anterior thoracolumbar reconstruction using either TMCs (n=16) or expandable cages (n=17) between June 2000 and September 2011 were included in this study. Clinical outcome was measured by visual analogue scale (VAS), American Spinal Injury Association (ASIA) scale and Low Back Outcome Score (LBOS) for functional neurological evaluation. The Cobb angle, body height of the fractured vertebra, the operation time and amount of intra-operative bleeding were measured in both groups. Results : In the expandable cage group, operation time and amount of intraoperative blood loss were lower than that in the TMC group. The mean VAS scores and LBOS in both groups were improved, but no significant difference. Cobb angle was corrected higher than that in expandable cage group from postoperative to the last follow-up. The change in Cobb angles between preoperative, postoperative, and the last follow-up did not show any significant difference. There was no difference in the subsidence of anterior body height between both groups. Conclusion : There was no significant difference in the change in Cobb angles with an inter-group comparison, the expandable cage group showed better results in loss of kyphosis correction, operation time, and amount of intraoperative blood loss.
Objective : In the cervical spine, many surgical procedures have been developed to achieve optimal results for various disorders, including degenerative diseases, traumatic injury, and tumor. In this study, we report our experience and follow-up results with a new surgical technique for cervical spine entitled posterior floating laminotomy (PFL) in comparison with conventional laminectomy and fusion (LF). Methods : Data for 85 patients who underwent conventional LF (n=66) or PFL (n=19) for cervical spine disorders between 2012 and 2019 were analyzed. Radiological parameters, including cervical lordosis (CL), T1 slope (T1S), segmental lordosis (SL), and C2-7 sagittal vertical axis (SVA), were measured with lateral spine X-rays. Functional outcomes, comprising the modified Japanese Orthopaedic Association (mJOA), neck disability index (NDI), and visual analog scale (VAS) scores, were also measured. For the patients who underwent PFL, postoperative magnetic resonance image (MRI) was performed in a month after the surgery, and the degree of decompression was evaluated at the T2-weighted axial image, and postoperative computed tomography (CT) was conducted immediately and 1 year after the operation to evaluate the gutter fusion. Results : There was no difference in CL, T1S, SL, and C2-7 SVA between the groups but there was a difference in the preoperative and postoperative SL angles. The mean difference in the preoperative SL angle compared with that at the last follow-up was -0.3° after conventional LF and 4.7° after PFL (p=0.04), respectively. mJOA, NDI, and VAS scores showed significant improvements (p<0.05) during follow-up in both groups. In the PFL group, postoperative MRI showed sufficient decompression and postoperative CT revealed gutter fusion at 1 year after the operation. Conclusion : PFL is a safe surgical method which can preserve postoperative CL and achieve good clinical outcomes.
Kim, Su Gyeong;Park, Eun Jin;Lim, Jae Eun;Do, Hyun Jeong;Kim, Jeong Yoon;Cho, Sung Woo;Yoon, Hyun Min;Kim, Cheol Hong
Journal of Acupuncture Research
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v.36
no.3
/
pp.166-171
/
2019
This study aimed to report the effect of Korean medical treatment including miniscalpel acupuncture on 2 patients who underwen tsurgery for rotator cuff tear. They were treated for almost 4 weeks at the Department of Acupuncture and Moxibustion, Dong-Eui University Korean Medicine Hospital. Visual analog scale (VAS), and range of movement (ROM) were used to evaluate treatment effects. In both patients, shoulder pain and restriction of shoulder joint movement improved after miniscalpel acupuncture treatment. In Case 1, shoulder pain decreased from a VAS score 8 to a VAS score 3, and ROM of the shoulder improved from flexion $100^{\circ}$ to $160^{\circ}$, extension $10^{\circ}$ to $30^{\circ}$, abduction $90^{\circ}$ to 1$30^{\circ}$, adduction $10^{\circ}$ to $40^{\circ}$, internal rotation $10^{\circ}$ to $50^{\circ}$, and external rotation $10^{\circ}$ to $50^{\circ}$. In Case 2, shoulder pain, which was rated a VAS score 8 at first-visit, disappeared, and ROM of the shoulder recovered to normal range. These results suggest miniscalpel acupuncture may contribute to the recovery process after rotator cuff tear surgery.
Processing steps such as washing and cutting, involved in preparing fresh-cut produce causes tissue damage, leading to rapid quality deterioration. Major defects of fresh-cut produce are discoloration, softening, off-odor development, and microbial growth. Packaging of fresh-cut produce has been changed to reduce these quality problems. Flexible packaging film is widely used to pack fresh-cut produce. Vacuum packaging was the popular packaging method in the beginning of fresh-cut industry in Korea. Vacuum packaging creates high $CO_2$ and low $O_2$ levels to control browning of fresh-cut produce. However, these conditions induce some visual defects and off-odor development. Discoloration problem was also found when fresh-cut produce was packaged with conventional packaging film or plastic tray. Modified atmosphere (MA) packaging is effective for prolonging shelf-life of fresh-cut produce by decreasing $O_2$ and increasing $CO_2$ concentration in the package. Retail MA packaging using different oxygen transmission rate (OTR) film and micro-perforated film has started to be applied to fresh-cut produce in Korea. Proper MA package design that provides optimum range of $O_2$ and $CO_2$ partial pressures is one of the major challenges in the industry. An initial package flushing with $N_2$ or an low $O_2$/high $CO_2$ atmosphere is also used to more rapidly establish steady-state MA condition. Film OTR and $O_2$ flushing affects the fermentative volatile production, off-odor development, electrolyte leakage, discoloration, $CO_2$ injury, microbial population of fresh-cut produce. There is also a demand for convenient packaging to attract consumers. Rigid fresh-cut produce container for retail market has increased since the packaging provides excellent protection from physical damage during transport. Rigid tray used as actual serving vessel for the consumer is increasing in Korea. The tray with flexible lid to wrap or seal fresh-cut produce is more and more gaining popularity. Further practical technology to control quality change and microbial growth for each fresh-cut product has been studied since various fresh-cut items were required. The fresh-cut industry also focuses on searching for more convenient and environmentally friendly packaging.
Background and Objectives Skin aging is reportedly associated with regulation in collagen and elastin synthesis. This study investigated the potential of combining light-emitting diode (LED) treatments using a 630-nm and 850-nm LED with simultaneous microcurrent application. Materials and Methods The dorsal skin of female pigs was treated with a home-use device. We examined the treatment effects using photography, thermocamera, microscopic pathology, and histological examination to determine the mechanism of action, efficacy, and safety of the procedure. A histological observation was performed using hematoxylin and eosin, Masson's trichrome, Victoria blue, and immunohistochemical staining. We also used the Sircol soluble collagen and elastin assay kit to measure the amounts of collagen and elastin in the porcine back skin tissue after 2 and 6 weeks. Results Evaluation by visual inspection and devices showed no skin damage or heat-induced injury at the treatment site. Histological staining revealed that accurate treatment of the targeted dermis layer effectively enhanced collagen and elastin deposition. Collagen type I, a protein defined by immunohistochemical staining, was overexpressed in the early stages of weeks 2 and 6. Combined therapy findings showed the superior capability of the 630-nm and 850-nm LED procedures to induce collagen; in contrast, elastin induction was more pronounced after microcurrent treatments. Conclusion The home-use LED device, comprising a combination of 630-nm and 850-nm LEDs and microcurrent, is safe and can be used as an adjunctive treatment for self-administered facial rejuvenation.
Background: We aimed to assess the effect of plate hook bending in treatment of acromioclavicular (AC) dislocation by analyzing clinical and radiological results according to the angle of the plate hook (APH). Methods: This was a retrospective, observational, case-control study including 76 patients with acute AC joint dislocation that were divided into two groups according to treatment with bent or unbent plate hook. The visual analog scale (VAS), the American Shoulder and Elbow Surgeons (ASES) shoulder score, and range of motion (ROM) were evaluated as clinical outcomes. Comparative coracoclavicular distance (CCD) was measured to evaluate radiological outcomes. Results: While the VAS and ASES of the bending group at 4 months after surgery were significantly higher (p=0.021 and p=0.019), the VAS and ASES of the bending group at other periods and ROM of the bending group showed no significant difference. The initial CCD decreased from 183.2%±25.4% to 114.3%±18.9% at the final follow-up in the bending group and decreased from 188.2%±34.4% to 119.1%±16.7% in the non-bending group, with no statistical difference (p=0.613). The changes between the initial and post-metal removal CCD were 60.2%±11.2% and 57.3%±10.4%, respectively, with no statistical difference (p=0.241). The non-bending group showed greater subacromial osteolysis (odds ratio, 3.87). Pearson's coefficients for the correlation between APH and VAS at 4 months after surgery and for that between APH and ASES at 4 months after surgery were 0.74 and -0.63 (p=0.027 and p=0.032), respectively. Conclusions: The APH was associated with improved postoperative pain and clinical outcomes before implant removal and with reduced complications; therefore, plate hook bending is more useful clinically during plate implantation.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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v.28
no.3
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pp.21-32
/
2022
Background: Instrument players are exposed to occupational musculoskeletal symptoms due to constant movement and strain to meet the needs of their audience. This can cause dissonance between the player and the instrument and can cause medical problems in the musculoskeletal system such as pain, tendinitis, muscle spasms, and joint hyperextension from overuse of body parts. Objective: The purpose of this study is to comparatively analyze the characteristics and occurrence of musculoskeletal symptoms in professional and student players, and to find out the awareness of the need for health care professionals and special exercise programs for orchestra players. Methods: The subjects were professional orchestral musicians 191 from the three symphony orchestras and music students 209 from the four universities volunteered to participate in this study; 393 subjects (98.25%) completed the questionnaire. symptom prevalence and related factors of playing-related musculoskeletal disorders (PRMDs) were surveyed with a self-administered questionnaire. Standardized Nordic Questionnaire was complemented by adding a visual-among scale and used to diagnose PRMD. Results: High prevalence of musculoskeletal complaints in both professional musicians (85.30%) and student musicians (82.30%). Professional musicians and student musicians also suffered the highest problem in shoulder and neck complaints. Significant differences were found between groups that recognized of necessity for specialized health professionals, professional organizations, and special programs for musicians. Conclusions: Professional musicians and student musicians, like orchestra players, are already exposed to overuse syndrome. However, student musicians lack awareness of the risk of injury compared to orchestra players. We suggest that an appropriate treatment management program for the prevention and early treatment of musculoskeletal system damage should be provided to performers at an early stage.
Background: This study aimed to evaluate the response rate to arthroscopic release treatment in adhesive capsulitis of the shoulder (ACS) for patients with refractory to conservative treatment. Methods: In this retrospective study, 51 patients (age mean, 49.1±5.6 years) with unilateral adherent capsule underwent arthroscopic releasing surgery for the shoulder capsule. Etiologies of the ACS in 30 patients were idiopathic: 10 patients were affected after surgery and 11 patients following trauma. The patients were evaluated in terms of shoulder function, satisfaction rate, pain intensity, and joint range of motion (ROM) based on a Constant score, a Simple Shoulder Test, the visual analog scale, and four movements, respectively. Results: The mean Constant score before surgery was 48.2±3.5 and reached 74.4±6 and 77.0±6.3 at 6 months and the final follow-up, respectively (p<0.001). The mean scores of pain intensity, a Simple Shoulder Test, and ROM showed significant improvement at all follow-ups (p<0.001). Sex, age, and diabetes did not have any significant effect on patient recovery. However, patients who experienced ACS after surgery had poorer results than others at all follow-up points. Conclusions: Arthroscopic releasing surgery of the shoulder in patients with ACS refractory to conservative treatment produces rare complications and an effective injury response. It seems that patients suffering ACS following surgery have a weaker response to the treatment.
Purpose: This study aimed to evaluate the effectiveness of deltoid ligament repair on syndesmotic stabilization in patients with acute ankle fractures with ruptured deltoid and syndesmotic ligaments. Materials and Methods: The medical records of 41 patients (41 ankles) who underwent surgery for Weber type B ankle fracture with ruptured deltoid and syndesmotic ligaments were retrospectively analyzed. The mean follow-up duration was 36 months (range 18~65 months). Patients were divided into two groups: those that underwent deltoid ligament repair (the deltoid group) and those who did not (the non-deltoid group). Both groups were also divided into two subgroups, namely, the D1/S1 group, which underwent syndesmotic screw fixation, or the D2/S2 group, which did not. Medial clear space (MCS), tibiofibular clear space (TFCS), anterior fibular line (AFL) ratio, and posterior fibular line (PFL) distance were measured, and visual analog scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS), and Foot Function Index (FFI) scores were evaluated. Results: TFCS changed significantly after surgery in the D2 and S1 groups (p=0.01, p=0.03, respectively). Subgroup MCSs, TFCSs, and AFL ratios were not significantly altered by surgery in the four subgroups (p=0.82, p=0.45, p=0.25, respectively). However, postoperative PFL distances were significantly different in the D2 and S1 groups and the S1 and S2 groups (p=0.02, p=0.02, respectively). Mean TFCS decreased significantly after surgery in the D2 and S1 groups. The postoperative VAS, AOFAS scores, and FFI were not significantly different between the subgroups (p=0.44, p=0.40, and p=0.46, respectively). Conclusion: Deltoid ligament repair seemed to restore ankle stability without addressing syndesmosis in Weber type B ankle fractures with rupture of deltoid and syndesmotic ligaments.
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