Hyung-Jin Chung, Yong-Bum Joo, Jae-Young Park, Woo-Yong Lee
Elbow pain is a common symptom encountered in clinical practice. Pathology can arise from any component of the joint, including the bone, tendons, ligament, bursa
{"title":"Differential Diagnosis of Elbow Pain","authors":"Hyung-Jin Chung, Yong-Bum Joo, Jae-Young Park, Woo-Yong Lee","doi":"10.12771/emj.2023.e13","DOIUrl":"https://doi.org/10.12771/emj.2023.e13","url":null,"abstract":"Elbow pain is a common symptom encountered in clinical practice. Pathology can arise from any component of the joint, including the bone, tendons, ligament, bursa","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"86 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135977395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Traumatic rupture of the extensor hallucis longus (EHL) is an uncommon finding in an outpatient setting. Surgical repair is typically necessary, particularly in chronic conditions that have persisted for six weeks or more. While several studies have reported EHL repair using autograft tendons, rehabilitation regimes vary, and standardized protocols have not yet been established. This case report presents with an inability to extend her left great toe. She underwent tendon reconstruction with an autograft semitendinosus tendon. At an 8-week follow-up, the patient reported greatly improved outcomes on the American Orthopaedic Foot and Ankle Society, Foot and Ankle Ability Measure, Foot and Ankle Disability Index questionnaire. Full recovery was achieved 12 weeks after surgery. The use of autograft semitendinosus tendon repair for chronic EHL tendon rupture, in conjunction with rehabilitation program, can be expected to yield favorable results.
{"title":"A 12-Week Rehabilitation Protocol for the Management of Chronic Extensor Hallucis Longus Rupture Repaired with an Autograft of the Semitendinosus Tendon","authors":"Astuti Pitarini, None Mitchel, Karina Sylvana Gani, Ratna Moniqa, Erica Kholinne","doi":"10.12771/emj.2023.e20","DOIUrl":"https://doi.org/10.12771/emj.2023.e20","url":null,"abstract":"Traumatic rupture of the extensor hallucis longus (EHL) is an uncommon finding in an outpatient setting. Surgical repair is typically necessary, particularly in chronic conditions that have persisted for six weeks or more. While several studies have reported EHL repair using autograft tendons, rehabilitation regimes vary, and standardized protocols have not yet been established. This case report presents with an inability to extend her left great toe. She underwent tendon reconstruction with an autograft semitendinosus tendon. At an 8-week follow-up, the patient reported greatly improved outcomes on the American Orthopaedic Foot and Ankle Society, Foot and Ankle Ability Measure, Foot and Ankle Disability Index questionnaire. Full recovery was achieved 12 weeks after surgery. The use of autograft semitendinosus tendon repair for chronic EHL tendon rupture, in conjunction with rehabilitation program, can be expected to yield favorable results.","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"220 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135977417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The elbow joint, with its intricate anatomy, plays a pivotal role in the upper limb's functional movements. Common surgical indications include epicondylitis, osteoarthritis, tendon tears, and neuropathies. Irrespective of the nature of surgery, appropriate postoperative rehabilitation is essential to enhance recovery, optimize functional outcomes, and minimize complications. Protective measures for the elbow vary based on the surgical procedure is performed. Extended postoperative immobilization is generally not advised. Temporary splints may be utilized to protect the soft tissues in the immediate aftermath of surgery, with patients advised to intermittently remove them to facilitate elbow movement. To increase mobility while ensuring the safety of repaired tendons or ligaments, articulated dynamic braces are recommended. This review delivers clinically useful recommendations specific to various surgical procedures, designed to be user-friendly even for non-specialists in orthopaedic surgery.
{"title":"Postoperative Rehabilitation of Elbow Pain","authors":"Hyojune Kim, Kyoung Hwan Koh, In-Ho Jeon","doi":"10.12771/emj.2023.e16","DOIUrl":"https://doi.org/10.12771/emj.2023.e16","url":null,"abstract":"The elbow joint, with its intricate anatomy, plays a pivotal role in the upper limb's functional movements. Common surgical indications include epicondylitis, osteoarthritis, tendon tears, and neuropathies. Irrespective of the nature of surgery, appropriate postoperative rehabilitation is essential to enhance recovery, optimize functional outcomes, and minimize complications. Protective measures for the elbow vary based on the surgical procedure is performed. Extended postoperative immobilization is generally not advised. Temporary splints may be utilized to protect the soft tissues in the immediate aftermath of surgery, with patients advised to intermittently remove them to facilitate elbow movement. To increase mobility while ensuring the safety of repaired tendons or ligaments, articulated dynamic braces are recommended. This review delivers clinically useful recommendations specific to various surgical procedures, designed to be user-friendly even for non-specialists in orthopaedic surgery.","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"45 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135977392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Recent advances in medicine have led to an increase in the number of children and adolescents treated for various chronic diseases and cancer. Increasingly sophisticated genetic analysis techniques have also clarified some genetic factors that contribute to bone fragility. Osteoporosis, characterized by reduced bone mass and skeletal fragility, can result from primary or secondary causes that originate in childhood and adolescence, which are critical periods for bone mineral acquisition. It is essential to identify children and adolescents at risk of fractures due to osteoporosis, and early intervention is crucial. Conservative management strategies, such as treating underlying diseases, replacing deficient hormones, providing nutritional support to meet calcium and vitamin D requirements, and encouraging regular physical activity, should be prioritized. Pharmacological treatment should be initiated in a timely manner following a comprehensive bone health examination. Intravenous pamidronate therapy has been safely and effectively administered to children and adolescents, although long-term follow-up is necessary. Further investigation is needed regarding bone fragility fractures of unknown etiology and the application of new medications for pediatric use.
{"title":"Diagnosis and Management of Osteoporosis in Children and Adolescents","authors":"Hye Young Jin, Eu Seon Noh, Il Tae Hwang","doi":"10.12771/emj.2023.e18","DOIUrl":"https://doi.org/10.12771/emj.2023.e18","url":null,"abstract":"Recent advances in medicine have led to an increase in the number of children and adolescents treated for various chronic diseases and cancer. Increasingly sophisticated genetic analysis techniques have also clarified some genetic factors that contribute to bone fragility. Osteoporosis, characterized by reduced bone mass and skeletal fragility, can result from primary or secondary causes that originate in childhood and adolescence, which are critical periods for bone mineral acquisition. It is essential to identify children and adolescents at risk of fractures due to osteoporosis, and early intervention is crucial. Conservative management strategies, such as treating underlying diseases, replacing deficient hormones, providing nutritional support to meet calcium and vitamin D requirements, and encouraging regular physical activity, should be prioritized. Pharmacological treatment should be initiated in a timely manner following a comprehensive bone health examination. Intravenous pamidronate therapy has been safely and effectively administered to children and adolescents, although long-term follow-up is necessary. Further investigation is needed regarding bone fragility fractures of unknown etiology and the application of new medications for pediatric use.","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"82 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135977399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elbow pain-related diseases constitute a significant portion of musculoskeletal conditions
{"title":"When a Patient’s Pain in the Elbow Turns into a Physician’s Pain in the Neck","authors":"Youngbok Kim","doi":"10.12771/emj.2023.e11","DOIUrl":"https://doi.org/10.12771/emj.2023.e11","url":null,"abstract":"Elbow pain-related diseases constitute a significant portion of musculoskeletal conditions","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"85 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135977396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alzheimer disease (AD) is a common neurodegenerative disorder, characterized by memory impairment, dementia, and diminished cognitive function. This disease affects more than 20 million people worldwide. Amyloid beta (Aβ) plaques and neurofibrillary tangles (NFTs) are important pathological markers of AD. Multiple studies have indicated a potential association between elevated cholesterol levels and increased risk of AD, suggesting that lowering the cholesterol level could be a viable strategy for AD treatment or prevention. Statins, potent inhibitors of cholesterol synthesis, are widely used in clinical practice to decrease the plasma levels of LDL cholesterol in patients with hyperlipidemia. Statins are known to play a neuroprotective role in limiting Aβ pathology through cholesterol-lowering therapies. In addition to Aβ plaques and neurofibrillary tangles, the brains of AD patients exhibit signs of oxidative stress, neuroinflammatory responses, and synaptic disruption. Consequently, compounds with antioxidant, anti-inflammatory, and/or neuroprotective properties could be beneficial components of AD treatment strategies. In addition to lowering LDL cholesterol, statins have demonstrated therapeutic efficacy in various forms, including antioxidant, anti-inflammatory, and neuroprotective effects. These properties of statins are potential mechanisms underlying their beneficial effects in treating neurodegenerative diseases. Therefore, this review was conducted to provide an overview of the protective effects of statins against AD.
{"title":"Protective Effects of Statins against Alzheimer Disease","authors":"Leila Rezakhani, Zahra Salimi, Fatemeh Zarei, Farshad Moradpour, Mohammad Rasool Khazaei, Mozafar Khazaei, Maryam Pourjalili","doi":"10.12771/emj.2023.e17","DOIUrl":"https://doi.org/10.12771/emj.2023.e17","url":null,"abstract":"Alzheimer disease (AD) is a common neurodegenerative disorder, characterized by memory impairment, dementia, and diminished cognitive function. This disease affects more than 20 million people worldwide. Amyloid beta (Aβ) plaques and neurofibrillary tangles (NFTs) are important pathological markers of AD. Multiple studies have indicated a potential association between elevated cholesterol levels and increased risk of AD, suggesting that lowering the cholesterol level could be a viable strategy for AD treatment or prevention. Statins, potent inhibitors of cholesterol synthesis, are widely used in clinical practice to decrease the plasma levels of LDL cholesterol in patients with hyperlipidemia. Statins are known to play a neuroprotective role in limiting Aβ pathology through cholesterol-lowering therapies. In addition to Aβ plaques and neurofibrillary tangles, the brains of AD patients exhibit signs of oxidative stress, neuroinflammatory responses, and synaptic disruption. Consequently, compounds with antioxidant, anti-inflammatory, and/or neuroprotective properties could be beneficial components of AD treatment strategies. In addition to lowering LDL cholesterol, statins have demonstrated therapeutic efficacy in various forms, including antioxidant, anti-inflammatory, and neuroprotective effects. These properties of statins are potential mechanisms underlying their beneficial effects in treating neurodegenerative diseases. Therefore, this review was conducted to provide an overview of the protective effects of statins against AD.","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"45 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135977391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mission and Goals of the New Editor of the Ewha Medical Journal","authors":"Sun Huh","doi":"10.12771/emj.2023.e9","DOIUrl":"https://doi.org/10.12771/emj.2023.e9","url":null,"abstract":"","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"45 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135977393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 44-year-old woman was referred to the cardiology department due to experiencing heaviness in both legs during exertion and decreased ankle-brachial indexes of 0.83 and 0.78, respectively. She had a mild case of aplastic anemia. Lower extremity computed tomographic angiography (CTA) revealed a total occlusion of the left iliac artery from the bifurcation of the abdominal aorta, which was reconstructed at the level of the common femoral artery (Fig. 1A, red arrow). Atherosclerotic plaque was clearly visible at the abdominal aorta (Fig. 1B, C). However, the occluded iliac artery showed thread-like hypoplasia without any definitive atherosclerotic occlusion (Fig. 1D, red arrow). Initially, we suspected congenital atresia of the iliac artery due to the patient's hypoplastic
{"title":"Fibromuscular Dysplasia Involving the Iliac Artery and Mimicking Atresia of the Left Iliac Artery","authors":"In Sook Kang","doi":"10.12771/emj.2023.e21","DOIUrl":"https://doi.org/10.12771/emj.2023.e21","url":null,"abstract":"A 44-year-old woman was referred to the cardiology department due to experiencing heaviness in both legs during exertion and decreased ankle-brachial indexes of 0.83 and 0.78, respectively. She had a mild case of aplastic anemia. Lower extremity computed tomographic angiography (CTA) revealed a total occlusion of the left iliac artery from the bifurcation of the abdominal aorta, which was reconstructed at the level of the common femoral artery (Fig. 1A, red arrow). Atherosclerotic plaque was clearly visible at the abdominal aorta (Fig. 1B, C). However, the occluded iliac artery showed thread-like hypoplasia without any definitive atherosclerotic occlusion (Fig. 1D, red arrow). Initially, we suspected congenital atresia of the iliac artery due to the patient's hypoplastic","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"81 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135977400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The review article explores recent advances in the surgical treatment of elbow pain, a common ailment that can significantly impair daily functioning. With a surge in elbow-related conditions such as tennis elbow, osteoarthritis, and nerve compression disorders, the necessity for surgical approaches has become paramount. This article provides an overview of the cutting-edge procedures now available, including minimally invasive arthroscopic surgery. These modern methods have been shown to significantly reduce recovery times and improve overall patient outcomes. The combination of surgical management and targeted rehabilitation ensures a comprehensive and personalized treatment plan for patients with various elbow pathologies. This article aims to shed light on these recent surgical interventions and their potential for advancing the management of elbow pain, emphasizing the ongoing trend toward precision, efficiency, and patient-centered care.
{"title":"The Recent Surgical Treatment of Elbow Pain","authors":"Erica Kholinne, In-ho Jeon, Jae-Man Kwak","doi":"10.12771/emj.2023.e15","DOIUrl":"https://doi.org/10.12771/emj.2023.e15","url":null,"abstract":"The review article explores recent advances in the surgical treatment of elbow pain, a common ailment that can significantly impair daily functioning. With a surge in elbow-related conditions such as tennis elbow, osteoarthritis, and nerve compression disorders, the necessity for surgical approaches has become paramount. This article provides an overview of the cutting-edge procedures now available, including minimally invasive arthroscopic surgery. These modern methods have been shown to significantly reduce recovery times and improve overall patient outcomes. The combination of surgical management and targeted rehabilitation ensures a comprehensive and personalized treatment plan for patients with various elbow pathologies. This article aims to shed light on these recent surgical interventions and their potential for advancing the management of elbow pain, emphasizing the ongoing trend toward precision, efficiency, and patient-centered care.","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135977390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain originating from the elbow can be due to issues affecting the joint itself or the structures surrounding it. These structures include the medial and lateral epicondyles, associated ligaments, the origins of wrist flexor and extensor muscles, the olecranon bursa, the distal biceps tendon, and the radial and ulnar nerves. Pain that appears to originate from a different location may actually be referred pain, potentially stemming from the neck (cervical radiculopathy) or the shoulder. Among complaints related to the elbow, lateral elbow pain is the most frequently reported. This pain could originate from the lateral epicondyle, the radiohumeral joint, or it could be referred pain from other areas. Medial elbow pain is the second most common complaint, often resulting from issues with the medial epicondyle or the ulnar nerve as it travels through the cubital tunnel. The biceps tendon is frequently the cause of anterior elbow pain. Patients who report swelling in the elbow are often experiencing olecranon bursitis. These conditions can often be effectively managed through conservative treatment. The aim of this article is to provide a structured approach to addressing patients with elbow pain, by detailing the common causes of such discomfort and exploring effective nonsurgical treatment options.
{"title":"Recent Nonoperative Treatment of Elbow Pain","authors":"Jung Won Han, Young Dae Jeon","doi":"10.12771/emj.2023.e14","DOIUrl":"https://doi.org/10.12771/emj.2023.e14","url":null,"abstract":"Pain originating from the elbow can be due to issues affecting the joint itself or the structures surrounding it. These structures include the medial and lateral epicondyles, associated ligaments, the origins of wrist flexor and extensor muscles, the olecranon bursa, the distal biceps tendon, and the radial and ulnar nerves. Pain that appears to originate from a different location may actually be referred pain, potentially stemming from the neck (cervical radiculopathy) or the shoulder. Among complaints related to the elbow, lateral elbow pain is the most frequently reported. This pain could originate from the lateral epicondyle, the radiohumeral joint, or it could be referred pain from other areas. Medial elbow pain is the second most common complaint, often resulting from issues with the medial epicondyle or the ulnar nerve as it travels through the cubital tunnel. The biceps tendon is frequently the cause of anterior elbow pain. Patients who report swelling in the elbow are often experiencing olecranon bursitis. These conditions can often be effectively managed through conservative treatment. The aim of this article is to provide a structured approach to addressing patients with elbow pain, by detailing the common causes of such discomfort and exploring effective nonsurgical treatment options.","PeriodicalId":197820,"journal":{"name":"The Ewha Medical Journal","volume":"84 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135977397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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