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경골의 만성 골수염 후 발생한 하퇴 전방의 난치성 피부 병변에 대한 치료
김형민(Hyoung Min Kim),이재영(Jae Young Lee),조형래(Hyung Lae Cho),조홍(Hong Jo),김덕희(Duc Hee Kim) 대한정형외과학회 2016 대한정형외과학회지 Vol.51 No.3
목적: 경골의 만성 골수염 후 발생한 하퇴 전방의 난치성 불량 피부 병변과 함께 동반된 표재성 또는 국소형 골 감염에 대해 골 성형술과 연부 조직 일차 봉합술을 시행한 후 임상적 결과를 보고하고자 한다. 대상 및 방법: 경골의 만성 골수염 후 하퇴 전방의 불량한 피부 병변과 함께 표재성 또는 국소형 골 감염이 합병된 7예를 후향적으로 분석하였다. 골수염 이환 기간은 평균 39년이었고 피부 병변을 절제한 후 골 성형술을 통해 감염성 골 병변을 제거하고 연부 조직 일차 봉합을 시행하였다. 술 후 피부 병변의 회복과 골 성형술에 의한 골 절제 정도를 측정하였으며 골수염의 재발을 포함한 합병증을 평가하였다. 결과: 절제된 불량 피부 병변의 크기는 평균 3.0×14.1 cm였고 전 예에서 결손부의 일차 봉합이 가능하였다. 전 예에서 하퇴 피부 병변이 복원되었으며 골 성형술로 절제된 골 범위는 경골 간부 전후 직경의 평균 18.7%였다. 최종 추시까지 골수염의 재발, 피로 골절과 같은 합병증은 없었다. 결론: 경골의 만성 골수염 후 골수강 내 감염은 치료되었으나 경골 전면부에 불량 피부 병변과 함께 표재성 또는 국소적 골 감염이 합병된 경우 골 성형술과 연부 조직 일차 봉합술은 다른 수술법에 비해 비교적 단순하면서도 골수염의 재발 없이 좋은 피부로 복원되는 효과적인 치료법이라고 생각한다. Purpose: We aimed to report the clinical results of diaphyseal osteoplasty and primary soft tissue closure in recalcitrant poor skin lesion with superficial or localized bone infection on the anterior shin after chronic osteomyelitis. Materials and Methods: We retrospectively reviewed 7 patients with poor shin skin lesion complicated by superficial and localized bone infection after chronic osteomyelitis. The average duration of chronic osteomyelitis was 39 years. After excision of the poor skin lesion, diaphyseal osteoplasty of the tibia was performed for the resection of infected bone and primary closure of the soft tissue defect. Postoperative results were evaluated with recovery of skin lesion, the amount of bone resection by osteoplasty and complications including recurrence of osteomyelitis. Results: Mean size of excised skin lesion during surgery was 3.0×14.1 cm and successful primary closures of the defect were possible in all cases. All shin skin lesions were recovered and the amount of resected bone was mean of 18.7% of the anteroposterior diameter of the tibia. There was no recurrence of skin lesion, osteomyelitis or stress fracture. Conclusion: After treatment of a previous intramedullary infection in chronic osteomyelitis of the tibia, recalcitrant poor shin skin lesion complicated with superficial or localized bone infection was effectively recovered by diaphyseal osteoplasty and primary soft tissue closure. This procedure is relatively simple compared to other surgeries and effective in recovery of healthy shin skin without recurrence of osteomyelitis.
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전경골 동맥에서 기시한 가성 동맥류의 코일 색전술: 증례 보고
왕태현,조형래,박기봉,김덕희,Wang, Tae-Hyun,Cho, Hyung-Lae,Park, Ki-Bong,Kim, Duc-Hee 대한족부족관절학회 2016 대한족부족관절학회지 Vol.20 No.1
Development of a pseudoaneurysm around the ankle is an uncommon complication after surgery. We experienced a case of a pseudoaneurysm, which developed from the anterior tibial artery. A 44-year-old woman had sustained painful swelling of her right ankle after the removal of implants for a distal fibular fracture. The pseudoaneurysm was confirmed by ultrasonography and angiography. The patient was treated with an intervention using a coil and recovered without further complaints. This case report aims to increase the awareness of this complication with review of literature.
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30세 이하 현역 국군 장병에서 발생한 단독 반월 연골판 파열의 관절경 소견에 따른 특징
황태혁 ( Tae Hyok Hwang ),박기봉 ( Ki Bong Park ),김덕희 ( Duc Hee Kim ) 대한스포츠의학회 2016 대한스포츠의학회지 Vol.34 No.1
Meniscal tears are a common source of knee pain in military personnel. We aimed to investigate the arthroscopic findings of isolated meniscal tears in soldiers younger than 30 years of age. Between May 2011 and April 2014, a total of 36 soldiers with 37 knees who underwent arthroscopic surgeries for isolated meniscal tears were included in this study. All patients were male soldiers and average age was 22 years (range, 19 to 30 years). Thirty patients (83%) were identified as having trauma in sports activity or military training, but no definite trauma was documented in six patients. We analyzed whether medial or lateral meniscus, the location and type of tear according to the arthroscopic findings. The incidence of meniscal tears was nearly same for both knees (right 18 and left 19). Twentysix of 37 tears (70%) were found in the lateral meniscus and 11 (30%) in the medial meniscus. Twenty-five tears (68%) were located in mid body and traumatic vertical type tears (65%) were more common than degenerative horizontal type tears (35%). Although our study based on relatively small cohort, isolated meniscal tears in young soldiers were usually resulted from trauma such as sports or ranger training and commonly located in lateral meniscus. Regarding the type of tear, traumatic vertical type was more common than degenerative horizontal type.
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