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*

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

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: 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

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

PURPOSE: To evaluate the necessity and effectiveness of a lunate excision in triscaphe fusion for the treatment of advanced Kienbock's disease. MATERIALS AND METHODS: Twenty-six patients who underwent a triscaphe fusion for Kienbock's disease (IIIb) were analyzed. Fifteen patients received triscaphe fusion only and 11 patients received triscaphe fusion and a lunate excision. The indication for a lunate excision included pain and limited motion due to posterior impingement associated with a severely collapsed lunate. The range of motion and modified Mayo wrist score in the two groups were compared. The carpal height ratio, ulnocarpal distance ratio and radioscaphoid angle were measured on the plain radiographs, and the presence of degenerative change was evaluated. RESULTS: The mean extension range was more preserved in the lunate excision group than in the lunate preserving group. Several radiology indices were similar in the two groups, but a degenerative change in the radioscaphoid joint was observed in 45.5% of the lunate excision group and in 13% of the lunate preserving group. CONCLUSION: When performing the triscaphe fusion in advanced Kienbock's disease, excision of the lunate can relieve the symptoms of posterior impingement. However, this procedure should be carried out carefully because degenerative changes in the radioscaphoid joint are frequently observed.
Humans ; Joints ; Osteonecrosis* ; Range of Motion, Articular ; Wrist

PURPOSE: This study assessed the early clinical and radiological results of Minimally Invasive Surgery- Quadriceps sparing total knee arthroplasty (MIS-QS TKA), and compared these results with those of conventional TKA. MATERIALS AND METHODS: Between August 2004 and March 2005, 17 patients with bilateral TKA on their one side using a regular procedure and the other using the MIS-QS technique were evaluated and compared. The clinical assessment was performed by measuring the range of motion, Knee Society Score, and a radiological evaluation by standing anteroposterior, supine lateral, and Merchant view preoperatively, 2 weeks, 6 weeks, 3 months and 1 year after surgery. Statistical analysis was performed using a paired t-test. RESULTS: The average range of knee motion was slightly larger in the MIS-QS group at all periodsbut there was no statistical difference between the two groups. The Knee Society Score was similar at the 3 month and 1 year periods. The alignment of the implants was satisfactory in both groups and postoperative patellar alignment checked in the Merchant view was better in the MIS-QS group at all periods. CONCLUSION: There were no differences in the clinical aspects at 1 year period between the two groups. However, the MIS-QS group showed better patellar alignment than the conventional group for up to 1 year.
Arthroplasty ; Humans ; Knee ; Range of Motion, Articular