Isolate fracture of lunate is very rare. The authors reported a neglected fracture of lunate which was founded incidentally after the dorsal wall fracture of triquetrum. Pain reduction and improvement of range of motion was achieved after excising the dorsal fragment of lunate.
Range of Motion, Articular

Range of Motion, Articular*

No abstract available.
Joints* ; Range of Motion, Articular* ; Spine*

OBJECTIVE: To compare optical motion capture system (MoCap), attitude and heading reference system (AHRS) sensor, and Microsoft Kinect for the continuous measurement of cervical range of motion (ROM). METHODS: Fifteen healthy adult subjects were asked to sit in front of the Kinect camera with optical markers and AHRS sensors attached to the body in a room equipped with optical motion capture camera. Subjects were instructed to independently perform axial rotation followed by flexion/extension and lateral bending. Each movement was repeated 5 times while being measured simultaneously with 3 devices. Using the MoCap system as the gold standard, the validity of AHRS and Kinect for measurement of cervical ROM was assessed by calculating correlation coefficient and Bland–Altman plot with 95% limits of agreement (LoA). RESULTS: MoCap and ARHS showed fair agreement (95% LoA<10°), while MoCap and Kinect showed less favorable agreement (95% LoA>10°) for measuring ROM in all directions. Intraclass correlation coefficient (ICC) values between MoCap and AHRS in –40° to 40° range were excellent for flexion/extension and lateral bending (ICC>0.9). ICC values were also fair for axial rotation (ICC>0.8). ICC values between MoCap and Kinect system in –40° to 40° range were fair for all motions. CONCLUSION: Our study showed feasibility of using AHRS to measure cervical ROM during continuous motion with an acceptable range of error. AHRS and Kinect system can also be used for continuous monitoring of flexion/extension and lateral bending in ordinary range.
Adult ; Head* ; Humans ; Neck ; Range of Motion, Articular*

Intramuscular stimulation (IMS) therapy has been used widely ever since Gunn introduced the effect of IMS in his study in 1980. Usually IMS has been based on Cannon's radiculopathic model, known for its effectiveness in chronic pain relief. In this study we systematically review the effectiveness and safety of IMS. In order to accomplish a systematic review, we searched for IMS-related studies through 12 bibliographical databases and 19 studies were included (4 randomized controlled trials (RCTs), 2 non-RCTs and 13 case reports/studies). Study selection was conducted independently by two researchers based on title and abstract. As a result, most included studies of 16 showed significant improvement in range of motion, decrease of drug consumption as well as pain relief after IMS treatment; the other 3 studies reported adverse events. In terms of the effectiveness of IMS, the results of intervention were good, so we concluded that IMS therapy is a useful method of pain treatment; with respect of safety, few adverse events that could have been caused by IMS were observed. However, it is not certain that there was a causal relationship between IMS and the adverse events that were reported due to a lack of evidence. Therefore, clinicians who have sufficient knowledge and experience of IMS will have to perform the procedure after thorough clinical examinations to determine its appropriateness for target patients. This study provided meaningful data on the current state of IMS treatment. We expect that the result of this study will stimulate further more extensive research on IMS.
Chronic Pain ; Humans ; Range of Motion, Articular

PURPOSE: Respiratory motion is a considerable inhibiting factor for precise treatment with stereotactic radiosurgery using the CyberKnife (CK). In this study, we developed a moving phantom to simulate three-dimensional breathing movement and investigated the distortion of dose profiles between the use of a moving phantom and a static phantom. MATERIALS AND METHODS: The phantom consisted of four pieces of polyethylene; two sheets of Gafchromic film were inserted for dosimetry. Treatment was planned to deliver 30 Gy to virtual tumors of 20, 30, 40, and 50 mm diameters using 104 beams and a single center mode. A specially designed robot produced three-dimensional motion in the right-left, anterior-posterior, and craniocaudal directions of 5, 10 and 20 mm, respectively. Using the optical density of the films as a function of dose, the dose profiles of both static and moving phantoms were measured. RESULTS: The prescribed isodose to cover the virtual tumors on the static phantom were 80% for 20 mm, 84% for 30 mm, 83% for 40 mm and 80% for 50 mm tumors. However, to compensate for the respiratory motion, the minimum isodose levels to cover the moving target were 70% for the 30~50 mm diameter tumors and 60% for a 20 mm tumor. For the 20 mm tumor, the gaps between the isodose curves for the static and moving phantoms were 3.2, 3.3, 3.5 and 1.1 mm for the cranial, caudal, right, and left direction, respectively. In the case of the 30 mm tumor, the gaps were 3.9, 4.2, 2.8, 0 mm, respectively. In the case of the 40 mm tumor, the gaps were 4.0, 4.8, 1.1, and 0 mm, respectively. In the case of the 50 mm diameter tumor, the gaps were 3.9, 3.9, 0 and 0 mm, respectively. CONCLUSION: For a tumor of a 20 mm diameter, the 80% isodose curve can be planned to cover the tumor; a 60% isodose curve will have to be chosen due to the tumor motion. The gap between these 80% and 60% curves is 5 mm. In tumors with diameters of 30, 40 and 50 mm, the whole tumor will be covered if an isodose curve of about 70% is selected, equivalent of placing a respiratory margin of below 5 mm. It was confirmed that during CK treatment for a moving tumor, the range of distortion produced by motion was less than the range of motion itself.
Polyethylene ; Radiosurgery* ; Range of Motion, Articular ; Respiration

OBJECTIVE: The offset connector can allow medial and lateral variability and facilitate intralaminar screw incorporation into the construct. The aim of this study was to compare the biomechanical characteristics of C7 intralaminar screw constructs with and without offset connector using a three dimensional finite element model of a C6-7 cervical spine segment. METHODS: Finite element models representing C7 intralaminar screw constructs with and without the offset connector were developed. Range of motion (ROM) and maximum von Mises stresses in the vertebra for the two techniques were compared under pure moments in flexion, extension, lateral bending and axial rotation. RESULTS: ROM for intralaminar screw construct with offset connector was less than the construct without the offset connector in the three principal directions. The maximum von Misses stress was observed in the C7 vertebra around the pedicle in both constructs. Maximum von Mises stress in the construct without offset connector was found to be 12-30% higher than the corresponding stresses in the construct with offset connector in the three principal directions. CONCLUSION: This study demonstrated that the intralaminar screw fixation with offset connector is better than the construct without offset connector in terms of biomechanical stability. Construct with the offset connector reduces the ROM of C6-7 segment more significantly compared to the construct without the offset connector and causes lower stresses around the C7 pedicle-vertebral body complex.
Biomechanics ; Immobilization ; Range of Motion, Articular ; Spine

PURPOSE: To compare the results of open fixation and closed percutaneous pinning in managing Jakob stage II lateral condylar fractures of children's elbow. MATERIALS AND METHODS: Since Febuary 2000, We operated 21 children with Jakob stage II lateral condylar fractures of elbow. Eleven of the 21 were treated with closed percutaneous pinning, open fixation was done to the other 10 children. Each patient was evaluated about range of motion, carrying angle, scar satisfaction and radiologic findings for comparison between closed pinning and open fixation groups. RESULTS: Open fixation group showed 3.8 degrees decrease of elbow motion while closed pinning group showed no significant decrease. Carrying angle and radiologic findings were not different between the two groups. Open fixation group expressed dissatisfaction to their scars (average 5.2 cm) whereas all the patients of closed pinning group were satisfied with their functional and cosmetic outcomes. CONCLUSION: In managing Jakob stage II lateral condyle fractures of children's elbow, closed percutaneous pinning was thought to be superior to open fixation because of the same functional outcome and much better cosmetic results.
Child* ; Cicatrix ; Elbow ; Humans ; Range of Motion, Articular

OBJECTIVE: To measure the lumbar segmental range of motion (ROM) with 3-dimensional motion analysis system and compare the results with radiologic ROM measurements. METHOD: Ten healthy adult volunteers were included. We attached surface markers at the corresponding skin surface of each lumbar vertebral bodies and measured lumbar segmental ROM in flexion-extension, right bending, left bending, axial rotation with 3-D motion analysis. We compared some of the results with radiologic segmental ROM measurements. RESULTS: In 3-D motion analysis, segmental ROM of flexion and extension, right bending, left bending, right rotation, left rotation were, respectively: 10.1degrees, 45degrees, 3.5degrees, 1.7degrees and 1.9degrees(L1-L2); 17.9degrees, 6.2degrees, 5.1degrees, 1.4degrees and 1.1degrees (L2-L3); 15.0degrees, 7.2degrees, 4.9degrees, 2.1degrees and 1.1degrees (L3-L4); 14.9degrees, 5.8degrees, 4.6degrees, 1.7degree and 1.6degree (L4-L5); 10.6degrees, 4.9degrees, 3.8degree, 2.6degree and 0.8degree (L5-S1). There was no statistically significant difference in segmental ROM between 3-D motion analysis measurements and radiologic measurements except L5-S1 right bending, L2-L3 and L5-S1 left bending. No statistical significant difference in lumbar flexion and bending ROM was found between two methods. CONCLUSION: 3-D motion analysis is a useful method when measuring the lumbar segmental range of motion and it has an advantage to analyze segmental lumbar motion with three directions simultaneously.
Adult* ; Humans ; Range of Motion, Articular* ; Skin ; Volunteers

INTRODUCTION: Most patellar fractures are transverse involving the central third. Open reduction and stabilization of transverse patellar fractures is indicated if there is more than 2-3 mm of fragment separation and/or articular incongruity. SURGICAL TECHNIQUE: This study describes a percutaneous 2 cannulated screws and modified tension band wiring technique to treat transverse patellar fractures. MATERIALS AND METHODS: We performed 30 cases of displaced transverse patellar fractures with this technique. The clinical outcomes of these patients were evaluated with simple radiographs, range of motion and Lyshom score. RESULTS: This technique has shown to provide satisfactory clinical results and excellent knee functions. CONCLUSIONS: This technique provide stable fixation, allows early motion exercise by minimizing injury to extensor mechanism and reduce cosmetic problem in scar.
Cicatrix ; Humans ; Knee ; Patella ; Range of Motion, Articular