슬관절 MRI에 의한 전, 후방 십자인대의 고찰 : 정상 한국 젊은 성인을 대상으로 A Study in Korean Young Adults

신현준 건국대학교 의과학연구소 1999 건국의과학학술지 Vol.9 No.-

It is important to know the normal size, shape, and signal intensity of anterior and posterior cruciate ligaments in the evaluation of knee injury. Many studies have reported findings of tear or rupture as well as normal anatomy of these structures. To our knowledge, however, no study has been published about the normal size, shape of cruciate ligaments in Korea. The purpose of this study is to know the normal appearance of cruciate ligaments on MRI. Ninety-four knees were evaluated in 47 Korean young volunteers(26 male and 21 female, 21-42 years old) who had no history of symptom or sign about knee joints. 1.5-T MR imager was used and sagittal scans of proton density image and T2WI, and coronal scans of T1WI were acquired. Length, thickness, width, and angle of cruciate ligaments were measured from the hard copy film. Mean length, thickness, and width of anterior cruciate ligament were 33.4±5.3mm, 6.4±1.8mm and 6.2±1.4mm in each. Mean length, thickness, and width of posterior cruciate ligament were 34.7±3.9mm, 5.4±1.0mm and 8.8±1.5mm in each. Mean angle of anterior cruciate ligament was 55.3±6.4°. Mean angle of posterior cruciate ligament was 132.9±12.9°, and curvature ratio was 0.21±0.06. No difference was noted between right and left side and between male and female in anterior and posterior cruciate ligaments, and these were some different from those of western people. So, these data can be useful for diagnostic criteria in rupture of cruciate ligaments in korean young adults and curvature ratio was 0.21±0.06. No difference was noted between right and left side and between male and female in anterior and posterior cruciate ligaments. Conclusion: Normal size and shape of he anterior and posterior cruciate ligaments of the knee were measured. These were some different from those of western people. So, these data can be useful for diagnostic criteria in rupture of cruciate ligaments in korean young adults.

Review of the Nomenclature of the Retaining Ligaments of the Cheek: Frequently Confused Terminology

Seo, Yeui Seok,Song, Jennifer Kim,Oh, Tae Suk,Kwon, Seong Ihl,Tansatit, Tanvaa,Lee, Joo Heon Korean Society of Plastic and Reconstructive Surge 2017 Archives of Plastic Surgery Vol.44 No.4

Since the time of its inception within facial anatomy, wide variability in the terminology as well as the location and extent of retaining ligaments has resulted in confusion over nomenclature. Confusion over nomenclature also arises with regard to the subcutaneous ligamentous attachments, and in the anatomic location and extent described, particularly for zygomatic and masseteric ligaments. Certain historical terms-McGregor's patch, the platysma auricular ligament, parotid cutaneous ligament, platysma auricular fascia, temporoparotid fasica (Lore's fascia), anterior platysma-cutaneous ligament, and platysma cutaneous ligament-delineate retaining ligaments of related anatomic structures that have been conceptualized in various ways. Confusion around the masseteric cutaneous ligaments arises from inconsistencies in their reported locations in the literature because the size and location of the parotid gland varies so much, and this affects the relationship between the parotid gland and the fascia of the masseter muscle. For the zygomatic ligaments, there is disagreement over how far they extend, with descriptions varying over whether they extend medially beyond the zygomaticus minor muscle. Even the 'main' zygomatic ligament's denotation may vary depending on which subcutaneous plane is used as a reference for naming it. Recent popularity in procedures using threads or injectables has required not only an accurate understanding of the nomenclature of retaining ligaments, but also of their location and extent. The authors have here summarized each retaining ligament with a survey of the different nomenclature that has been introduced by different authors within the most commonly cited published papers.

Review of the Nomenclature of the Retaining Ligaments of the Cheek: Frequently Confused Terminology

서의석,Jennifer Kim Song,오태석,권성일,Tanvaa Tansatit,이주헌 대한성형외과학회 2017 Archives of Plastic Surgery Vol.44 No.4

Since the time of its inception within facial anatomy, wide variability in the terminology as well as the location and extent of retaining ligaments has resulted in confusion over nomenclature. Confusion over nomenclature also arises with regard to the subcutaneous ligamentous attachments, and in the anatomic location and extent described, particularly for zygomatic and masseteric ligaments. Certain historical terms—McGregor’s patch, the platysma auricular ligament, parotid cutaneous ligament, platysma auricular fascia, temporoparotid fasica (Lore’s fascia), anterior platysma-cutaneous ligament, and platysma cutaneous ligament—delineate retaining ligaments of related anatomic structures that have been conceptualized in various ways. Confusion around the masseteric cutaneous ligaments arises from inconsistencies in their reported locations in the literature because the size and location of the parotid gland varies so much, and this affects the relationship between the parotid gland and the fascia of the masseter muscle. For the zygomatic ligaments, there is disagreement over how far they extend, with descriptions varying over whether they extend medially beyond the zygomaticus minor muscle. Even the ‘main’ zygomatic ligament’s denotation may vary depending on which subcutaneous plane is used as a reference for naming it. Recent popularity in procedures using threads or injectables has required not only an accurate understanding of the nomenclature of retaining ligaments, but also of their location and extent. The authors have here summarized each retaining ligament with a survey of the different nomenclature that has been introduced by different authors within the most commonly cited published papers.

발목관절 가쪽인대의 형태계측과 자기공명영상

정인혁,이혜연,서진석,이우형,장준섭 대한해부학회 1998 Anatomy & Cell Biology Vol.31 No.2

전방 십자인대의 파열시의 자기공명영상:직접소견의 중요성

신현준,이창희,최영칠,전혜정,박정희,김동헌 건국대학교 의과학연구소 2001 건국의과학학술지 Vol.11 No.-

It is Important to know the normal size, shape, and signal intensity of anterior cruciate ligament in the evaluation of knee injury Many studies have reported findings of tear or rupture as well as normal anatomy of these structure, especially with MR images. To our knowledge, there are few studies about normal structures of anterior cruciate ligament in MR images. The purpose of this study is to compare normal finding with tear of anterior cruciate ligament on MRI. Twenty-three cases with rupture of anterior cruciate ligament were evaluated on MRI, measuring the length, thickness, width of anterior cruciate ligament, and angles of anterior and posterior cruciate ligaments. Mean length, thickness, and width of anterior cruciate ligament in patients with rupture were 37.7±4.8mm, 9.0±1.2mm, 8.0±0.8mm, and mean angles of anterior cruciate ligament, and posterior cruciate ligament were 48.1±9.6˚, 118.8±13.1˚. Curvature ratio of posterior cruciate ligament was 0.25±0.09. The results showed significant differences between normal persons and patients with complete or partial rupture, and the mean angle and curvature ratio of posterior cruciate ligament which are known to related with indirect sign in tear of anterior cruciate ligament showed significant differences between ours and that of western countries. These results will be useful in the evaluation of patient wish rupture of anterior cruciate ligament, especially on MRI.

자기공명영상을 이용한 반월대퇴인대의 빈도와 분류

조재민 대한영상의학회 1996 대한영상의학회지 Vol.34 No.5

Purpose: To demonstrate the incidence and variation of the meniscofemoral ligament in Koreans. Materials and Methods: A total of 100 MR studies of 95 patients were reviewed with special attention to the appearance and incidence of the meniscofemoral ligaments. The ligament of Wrisberg was classified according to proximal insertion: type I, insertion at the posterofemoral condyle ; type II, insertion at the distal portion of the posterior cruciate ligament ; type III, insertion at the distal portion of the posterior cruciate ligament. On T2-weightedimages, the high signal at the meniscal insertion of the meniscofemoral ligament was classified according to itsshape. Results: The ligament o Humprey was observed in 17 cases and the ligament of Wrisberg was in 90:type I in41 cases;type II, 19 cases;type III, in 28 cases;unclassified, in 2 cases. In 77 cases, the cleft with high signal intensity was seen between the meniscofemoral ligament and the posterior cruciate ligament. Conclusion : From ourresults, the incidence of the ligament of Wrisberg on MRI was moe prevelant than the ligament of Humprey. An exact knowledge of the meniscofemoral ligament could be helpful in distinguishing it from pathologic lesions.

Ion Implantation으로 Ca를 첨가한 단결정 $Al_2$O$_3$의 Crck-Like Pore의 Healing 거동-H. Hexagonal Ligaments and Type of Healing

김배연 한국세라믹학회 1999 한국세라믹학회지 Vol.36 No.8

Ion implantation, photo-lithography, Ar ion milling과 hot press 법을 이용한 micro-fabrication techrique을 사용하여 고순도 알루미나 단결정인 사파이어의 내부에, 조절된 Ca의 첨가량을 갖고 있는, crack과 비슷한 형태의 기공들을 형성시켰다. 이 bi-cryslal을 각각의 온도에서 열처리하여 Ca 이온이 고온에서 알루미나의 morphology와 hcaling에 미치는 영향을 관찰하였다. 열처리 온도가 올라감에 따라서 crack-like pore의 내부에 hcxagonal bridging ligaments가 생성되었는데, 열처리 온도와 Ca의 첨가량이 증가할수록 크기가 커지는 것을 관찰할 수 있었고, 생성된 hexagonal bndgmg ligaments는 열처리가 진행됨에 따라 서서히 커지면서 모서리가 둥글어지는 현상을 관찰할 수 있었다. Bicrystal 내부에 형성된 crack-like pore는 열처리가 진행되면서 edge regression. ligamcnt growth 및 flow의 3가지의 특징적인 형태로 진행되었다. 이때 edge regression은 상대적으로 저온에서부터 전체 crack-like pore에서 서서히 일어나기 시작하였으며, ligament growth는 일부 crack-like pore에서 진행되있으며, 대단히 빠른 속도로 crack healing이 진행됨을 추정할 수 있었다. Flow는 $1800^{\circ}C$ 이상의 고온에서 모든 crack-like pore에 걸쳐서 느리게 일어남을 알 수 있었다. Inner crack-like pores with controlled amount of Ca impurity level in the high purity alumina single crystal sapphire had been created by micro-fabrication technique which includes ion implantation photo-lithography Ar ion milling and hot press technique. The morphological change and the healing of crack-like pore in the Ca doped high purity single crystal alumina during high temperature heat treatment in vacuum were observed using optical microscopy. The hexagonal bridging ligaments were developed and the size of hexagonal bridging ligaments had been increased with temperature and Ca amount and had grown to their corner rounded. It appeared that the hexagonal bridging ligaments would have an equilbrium size with temperature and the amount of Ca addition. Three kinds of crack-like pore healing type were observed. Edge regression and ligament growth were observed from relatively low temperature in the crack-like pore. Edge regression were found in almost all of the crack-like pore but the ligament growth were found only in the several crack-like pores accelerating heating very fast. Flow type healing was observed above $1800^{\circ}C$ and It healed the crack-like pore very slowly.

Effect of Deltoid Ligament Repair on Syndesmotic Stabilization in Patients with Ankle Fractures

김대욱,최홍준 대한족부족관절학회 2023 대한족부족관절학회지 Vol.27 No.3

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 dif- ferent 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.

급성 및 만성 전방 십자인대 파열의 구분에 있어서 조영증강자기공명영상의 역할

이은정,지원희,임수아,천호종,정현석,김수영,권태안,송선화,최규호 대한영상의학회 1998 대한영상의학회지 Vol.39 No.1

Purpose : To evaluate the efficacy of fat-suppressed gadolinium-enhanced MR imaging in differentiating acute from chronic ligament tears of anterior cruciate ligament. Materials and Methods : MR images of 22 patients with arthroscopically proven complete tear of the anterior cruciate ligament were retrospectively reviewed. The interval between injury and MR examination was one day to seven years. When ligament tear was detected on MR image withe three months of injury, the case was considered acute; if detected after three months had elapsed, it was judged to be chronic. The extent of contrast enhancement was graded as 1, 2 or 3; grade 1, enhancement was confined to the expected ligament region; grade 2, enhancement extended to the joint capsule; grade 3, enhancement extended beyond the joint capsule. The grades of contrast enhancement correlated with the acute and chronic stages of ligament tears. Associated bone bruise and/or adjacent soft tissue edema were also evaluated. Results : Among15 patients with acute ligament tear, nine (60%) showed grade 3 enhancement; among seven in whom tearing was chronic, four (57%) showed grade 1 enhancement. Bone bruising was present in 100% of acute tears (15/15) and 29%of chronic tears (2/7). Soft tissue edema was associated in 87% of acute tears (13/15) and 29% of chronic tears(2/7). Conclusion : Fat-suppressed gadolinium-enhanced MR imaging could help differentiate acute from chronic tears of anterior cruciate ligament, as well as bone bruising and tissue edema.

Topographic and Histologic Analysis of the Collateral Ligament Complex around the Elbow

Jong-Pil Kim,박지강,Joon-Young Yoo,Won-Jeong Shin,Jeong-Sang Kim,Young-IL Kim 대한수부외과학회 2021 대한수부외과학회지 Vol.26 No.3

Purpose: The purpose of this study was to evaluate topographic anatomy of the footprints of key ligaments of the elbow and assess their relationships with bony parameters using micro-computed tomography (micro-CT). Additionally, the ratios of type I/III collagen at the medial collateral ligament (MCL) and lateral collateral ligament (LCL) of elbow were investigated. Methods: Eleven cadaveric elbows attached by both the MCL and LCL were scanned using micro-CT and reconstructed three-dimensionally. Additionally, the ligaments were examined under polarized light microscopy to determine the histological characteristics of collagen patterns. Results: Areas of footprints of the MCL and LCL attaching onto the humerus were 133.2±25.8 mm² and 128.3±23.2 mm², respectively. Footprint sizes of anterior and posterior bundles of the MCL in the proximal ulna and lateral ulnar collateral ligament (LUCL) attaching to the proximal ulna averaged to 109.9 mm², 89.2 mm², and 89.7 mm², respectively. There were a positive correlation between footprint size of the MCL and LUCL at the humeral side and a negative correlation between the footprint size of the MCL at humeral side and maximal diameter of the radial head. The collagen I/III ratio of the humeral attachment of the MCL was higher than distal attachment of the MCL. Conclusion: This study provides a better understanding of the pathologies of the MCL and LCL complex of the elbow and their relationships with osseous anatomy and may assist the clinician with an anatomic reconstruction of the ligaments.