Fracture and fracture-dislocation of the ankle may be caused by a variety of mechanisms. In addition to the fracture, injury of soft tissue such as ligaments, tendons, nerves, and muscles may occur. Among these, tibialis posterior tendon injury is difficult to identify due to swelling and pain at the fracture site. There is no clear finding in radiological examination, therefore, it is found during surgery. In this case, irreducible fracture-dislocation of the ankle due to tibialis posterior tendon interposition was observed after the primary operation. The authors obtained satisfactory results in performance of a secondary operation assisted with arthroscopy.
Ankle Fractures ; Ankle* ; Arthroscopy ; Ligaments ; Muscles ; Tendon Injuries ; Tendons*

The successful closure of a fistula clearly involves application of spectrum of techniques depending variable factors. There was variety of opinions regarding the timing and optimum surgical technique for repair of fistula. Several muscles and myocutaneous flaps are applicable to a variety of tissue defects. The gracilis muscle is especially useful as adjuncts for wound coverage, vaginal or penile reconstruction and as interpositional tissue for the closure of various fistulas. We experienced two cases of female urinary tract fistula treated with gracilis muscle flap successfully.
Female* ; Fistula* ; Humans ; Muscles ; Myocutaneous Flap ; Urinary Tract* ; Wounds and Injuries

Golf has become an increasingly popular sport worldwide. In a survey done by the National Statistical Office of Korea in 2004, it is shown that 3.3% of Koreans who are 15 or older, which is about 1.27 million people, have played golf. Unfortunately, despite the rising popularity of golf, the research on the prevention and treatment of golf-related injuries has been quite lacking in Korea. In terms of sports injuries, golf is considered to have a medium-class injury potential, with most injuries resulting from overuse but other causes such as lack of flexibility, unbalanced muscles, failure in condition management, and inadequate stretching and warm-up/cooldown exercises are also possible. Furthermore, many golfers tend to force themselves into more exercises and rounds even when not having been fully recovered from the initial injury, giving rise to secondary injuries. The prevalence of golf-related injuries varies greatly among researchers, but even with the average of 50%, it can be assumed that about 600,000 Korean golfers are suffering from various kinds of pain and discomfort. The aim of this review is to understand the causes of gold-related injuries and the strategies for the treatment and prevention thereof.
Athletic Injuries ; Exercise ; Golf ; Korea ; Muscles ; Pliability ; Prevalence ; Rehabilitation* ; Sports

PURPOSE: The aim of this study is to investigate the biomechanical and histological changes in the muscles after tendon injury that have been little studied previously. MATERIALS AND METHODS: Triceps insertion was tenotomized on the left hidlimbs of 60 rabbits. Mechanical extension testing with Instron (rate: 10 mm/min) was performed 1, 2, 4, 8, 12 and 16 weeks after tenotomy in vivo. A load deformation curve was obtained, and this was analyzed in terms of strength and deformation at the elastic limit and at the point of maximal load. Histologic changes were observed after H < E staining and Matson s trichrome staining to measure the percentage area of collagen fibers. RESULTS: Between weeks 1 and 4, the excursion range fell gradually, and after that period, this value showed little changes. After its initial period of disequilibrium, the muscle regained its elastic nature within its newly formed excursion range. The average amount of collagen fibers increased gradually after tenotomy until 8th week. CONCLUSIONS: unless tendon ruptures are repaired early, the accompanying muscle would be irreversibly damaged, both bimechanically and histologically.
Collagen ; Muscles ; Rabbits ; Rupture ; Tendon Injuries ; Tendons ; Tenotomy*

Recently the interest in minimal invasive surgery for total hip arthroplasty is increasing due to its advantages of less soft tissue injury, less postoperative pain, early rehabilitation and cosmesis. There are two methods of minimal invasive surgery for total hip arthroplasty; one incision and two incision technique. The more common method is the one incision technique and among them, anterolateral and posterior or posterlateral method are most common. This one incision method reduces the length of incision. Two incision method was developed by Mears and Berger to reduce the degree of trauma to the muscles and tendons as well as to reduce the incision size. But the minimal invasive total hip arthroplasty has some potency of development of complications due to smaller operation field. So the minimal invasive total hip arthroplasty should be done only by experienced surgeons with sufficient training and adequate equiments.
Arthroplasty ; Hip ; Muscles ; Pain, Postoperative ; Soft Tissue Injuries ; Tendons

Golf has become an increasingly popular sport worldwide. In a survey done by the National Statistical Office of Korea in 2004, it is shown that 3.3% of Koreans who are 15 or older which is about 1.27 million people have played golf. Unfortunately, despite the rising popularity of golf, the research on the prevention and treatment of golf related injury was quite lacking in Korea. In terms of sports injuries, golf is considered to have a medium-class injury potential, with most injuries resulting from overuse but other causes such as lack of flexibility, unbalanced muscles, failures in condition management, inadequate stretching and warm-up/cool-down exercises are also possible. Furthermore, many golfers tend to force themselves in more exercises and rounds even when not fully recovered from the initial injury, risking secondary injuries. The prevalence of golf-related injuries varies much among researchers, but even with the average of 50%, it can be assumed that about six hundred thousand Korean golfers are suffering from various pain and discomfort. It was the purpose of this review to understand the causes of injury, treatment and prevention of golf-related injuries.
Athletic Injuries ; Exercise ; Golf* ; Korea ; Muscles ; Pliability ; Prevalence ; Sports

Thoracic disc herniation is a rare condition in which a posterior approach, extrapleural approach, posterolateral approach, or transthoracic approach is currently used. The posterior approach is not recommended in thoracic disc herniation surgery because of the risk of spinal cord injury. The transthoracic approach makes it possible to remove the intervertebral disc and is considered a standard method. However, due to an extensive transverse skin incision, division of the latissimus dorsi muscles, and rib resection, the conventional open approaches involve a risk of complications, such as infection and post-thoracotomy pain syndrome; and a long period of rehabilitation and recovery is required. Excision of the intervertebral disc under thoracoscopic guidance can reduce the damage to the skin and muscles, but the equipment and surgical materials are expensive and a long learning curve is required. Therefore, we report a case and a new muscle splitting transthoracic approach that can be performed by incising 10 cm of skin longitudinally and preserving the serratus anterior and latissimus dorsi muscles.
Intervertebral Disc ; Learning Curve ; Muscles ; Rehabilitation ; Ribs ; Skin ; Spinal Cord Injuries ; Superficial Back Muscles*

Acupuncture Therapy ; Diagnostic Errors ; Femur ; injuries ; Humans ; Male ; Middle Aged ; Muscles ; injuries ; Muscular Diseases ; diagnosis ; therapy

Dysphagia secondary to peripheral cranial nerve injury originates from weak and uncoordinated contraction-relaxation of cricopharyngeal muscle. We report on two patients who suffered vagus nerve injury during surgery and showed sudden dysphagia by opening dysfunction of upper esophageal sphincter (UES). Videofluoroscopy-guided balloon dilatation of UES was performed. We confirmed an early improvement of the opening dysfunctions of UES, although other neurologic symptoms persisted. While we did not have a proper comparison of cases, the videofluoroscopy-guided balloon dilatation of UES is thought to be helpful for the early recovery of dysphagia caused by postoperative vagus nerve injury.
Cranial Nerve Injuries ; Deglutition Disorders ; Dilatation* ; Esophageal Sphincter, Upper* ; Humans ; Muscles ; Neurologic Manifestations ; Vagus Nerve Injuries* ; Vagus Nerve*

BACKGROUNDPectoralis major tendon rupture is a relatively rare injury leading to both functional and cosmetic deficiency. The peak torque of the pectoralis major is significantly decreased after conservational treatment of a total rupture. We suppose that surgical intervention is better choice.

METHODSWe retrospectively evaluated 12 patients who were diagnosed with distal pectoralis major muscle rupture and underwent operation in our institute from 1993 to 2007. All patients were male with a mean age of 32 (19 - 54) years. In 4 patients, tendon reconstruction was accomplished by fixing the tendon to the humerus using sutures passed through predrilled humeral bone tunnels. In 8 patients, tendon reconstruction was accomplished by directly suturing the muscle to the tendon. All patients followed an accelerated rehabilitation protocol. Treatment results were evaluated according to the following criteria: (1) visual analogue pain scale, (2) isokinetic strength measurements, (3) range of motion of shoulder joint, (4) cosmetic result, and (5) postoperative sports activity performance. In this study, we aimed to describe our surgical technique of reconstruction of the rupture of pectoralis major muscle and to summarize the clinical results of the operative treatment.

RESULTSAt the final follow-up examination (6.5 years postoperatively), only nine patients were available for evaluation. Three of them had excellent results, and five had good results, while one had poor results. Eight of the patients were able to return to their preinjury level of sporting activity. In summary, 89% of the patients achieved excellent or good results.

CONCLUSIONSurgical treatment by anatomic tendon repair and accelerated rehabilitation can make recovery of strength and function of the pectoralis major muscle.

Humans ; Male ; Middle Aged ; Pectoralis Muscles ; injuries ; surgery ; Rupture ; surgery ; Tendon Injuries ; surgery ; Treatment Outcome ; Young Adult