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대퇴골두 무혈성괴사에서 시행한 핵심감압술 및 압박 골이식술
정광환 ( Kwang Hwan Jung ),장재석 ( Jae Suk Jang ),최영락 ( Young Rock Choi ) 대한고관절학회 2005 Hip and Pelvis Vol.17 No.4
목적: 대퇴골두 무혈성 괴사에서 핵심 감압술 및 압박 골이식술의 결과를 괴사부위의 크기와 위치에 따라 알아보고자 하였다. 대상 및 방법: 1996년 1월부터 2002년 9월까지 대퇴골두 무혈성괴사로 진단받고 핵심 감압술과 압박골이식술을 시행한 후 최소 2년이상 추시 가능했던 64명, 95예의 고관절을 대상으로 하였다. 남녀수는 각각 46명(71예), 18명(24예)였고, 나이는 평균 36.6(16~53)세였으며, 추시기간은 평균 43.3(24~95)개월이었다. 술 전 자기공명영상 소견상 괴사의 크기, 위치에 따른 수술 결과의 차이를 x2 -test와 Fisher`s exact test를 이용하여 비교 분석하였다(p<0.05). 결과: 임상적 진행은 21예(22.1%)에서 발생하였으며, 그 중 괴사의 크기가 50%이상인 경우가 17예(80.9%)였고, 모든 예에서 외측에 위치하였다. 방사선학적 진행은 51예(53.7%)에서 발생하였으며, 그 중 괴사의 크기가 50%이상인 경우가 28예(54.9%), 외측에 위치한 경우가 50예(98.0%)였다. 임상적 실패는 16예(16.8%)에서 발생하였으며, 그 중 괴사의 크기가 50%이상인 경우가 13예(81.3%)였고, 모든 예에서 외측에 위치하였다. 결론: 1. 괴사 부위의 크기는 클수록, 괴사 위치가 외측에 위치할수록 술 후 결과가 좋지 않았다. 2. 방사선학적 진행은 전체의 53.7%에서 발생하였으나, 인공 고관절 전치환술로 전환된 것은 16.8%에서만 발생한 것은 압박 골이식술(impaction bone graft)에 의해 대퇴골두가 강해진 것으로 생각한다. 3. 보다 더 긴 추시관찰이 필요하리라 생각한다. Purpose: To analyse the results of a core decompression and impaction bone graft according to necrosis size and location. Materials and Methods: Between Jan. 1996 and Sep. 2002, 64 patients (95 hips) who were followed up for a minimum of 2 years were studied. Forty-six (71 hips) were male and 18 (24 hips) were female. The mean age was 36.6 (16-53) years and the average follow up was 43.3(24~95) months. The surgical results were analysed using x2-test and Fisher`s exact test according to necrosis size and location. Results: Clinical progression was seen in 21 cases (22.1%), of which 17 cases had a lesion more than 50%. All 21 cases were located laterally. Radiologic progression was seen in 51 cases (53.7%), of which 28 cases had a lesion size involving more than 50%, and 50 cases were located laterally. Clinical failure was seen in 16 cases (16.8%), of which 13 cases had a lesion size involving more than 50%, and all 16 cases were located laterally. Conclusion: 1. The surgical results were worse when the lesion was larger and laterally positioned. 2. Radiologic progression was seen in 53.7% of cases, but conversion to total hip arthroplasty was seen in 16.8%, which was due to increased strength of femoral head. 3. To confirm these study results, longer follow up study is needed.
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국내 프로 축구 리그 경기에서 즉각적인 교체가 이루어진 부상의 발생률과 특징
박기봉 ( Ki-bong Park ),정광환 ( Kwang-hwan Jung ),김충린 ( Chung-reen Kim ),황일영 ( Il-yeong Hwang ),장성민 ( Seong-min Jang ) 대한스포츠의학회 2020 대한스포츠의학회지 Vol.38 No.3
Purpose: To identify the incidence and characteristics of immediate substitutions of injured players that occurred during Korean professional football league matches. Methods: This study included injuries that resulted in immediate substitutions of injured players during Korean professional football league matches. The match broadcasting records were used to check the date of the match, home-away matches, the team to which players belong, the position on the field of play, and the time of injury. The match recording videos were used to evaluate the injury mechanism and the injured area. Results: In 228 matches, 66 immediate substitutions of injured players occurred, with an incidence rate of 0.3 per match. Total number of substitutions due to injuries most frequently occurred in May, with 15 substitutions in 30 matches; however, after considering the number of substitutions per match in each month, November was the most severe month with 0.53 substitutions after injuries per match. Most frequently injured players were defenders (36.4%), followed by midfielders, forwards, and goalkeepers. Immediate substitutions of injured players took place 32 times in the first half and 34 times in the second half. 51.5% of all injuries were related to collisions, and injuries to the knee and thigh accounted for 45.5% of all injuries. Conclusion: There were 66 immediate substitutions of injured players during a single season of the Korean professional football league, with 0.3 substitutions after injuries per match. To prevent and manage serious injuries that can occur during a football match, a thorough analysis of risk factors of injuries that lead to immediate substitution is required.
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이채칠 ( Chae Chil Lee ),조성도 ( Sung Do Cho ),고상훈 ( Sang Hun Ko ),정광환 ( Kwang Hwan Jang ),곽창열 ( Chang Yeul Gwak ),정지영 ( Ji Young Jeong ) 대한슬관절학회 2006 대한슬관절학회지 Vol.18 No.2
목적: 슬관절 전치환술 후 발생한 불안정성의 양상과 치료 결과에 대해 알아 보고자 하였다. 대상 및 방법: 슬관절 전치환술을 시행 받고, 슬관절의 불안정성을 주소로 재치환술을 시행한 환자 8명의 9례를 대상으로 불안정성 증상의 발현 시기, 양상 및 주 원인, 치료 방법 및 결과를 분석하였다. 추시 기간은 평균 31개월이었다. 결과: 증상 발현 시기는 평균 10.1개월(8일~4년 4개월)이었다. 불안정성의 양상은 전-후방 불안정성이 2례, 내-외측 불안 정성이 5례, 범 불안정성이 2례였다. 치료는 더 두꺼운 폴리에틸렌 삽입물로 교정된 경우가 1례, 측부 인대의 복원 또는 재건술과 더 두꺼운 폴리에틸렌 삽입물의 사용을 같이 시행하여 교정된 경우가 5례, 굴곡-신전 간격의 불균형을 복구할 수 없어 제한형 치환물을 이용하여 교정된 경우가 3례였다. 모든 환자에서 슬관절의 안정성을 얻었으며, KSS 기능 점수와 슬관절 점수는 수술 전 평균 55, 56점에서 수술 후 88.8, 91점으로 향상되었다. 결론: 슬관절 전치환술 후 발생한 불안정성에 대하여 적극적인 측부 인대의 복원 또는 재건술과 폴리에틸렌 삽입물의 교체를 병행하여 교정하였고, 교정이 되지 않는 심한 경우에는 제한형 치환물을 이용한 재치환술로 좋은 결과를 얻었으며, 장기 추시가 필요할 것으로 생각된다. Purpose: To evaluate the patterns and the treatment of instability after primary TKA. Material & method: We studied 8 patients (9 cases) who had instability after TKA. We analyze the onset of symptom, patterns and main causes of instability, method of treatment, and results. The average follow-up period was 31 months. Result: Average onset of symptom after TKA was 10.1 month (8 day -4 years 4 month). The patterns of instability included anterior/posterior instability in 2, valgus/varus instability in 5 and global instability in 2. The treatments were thicker polyethylene exchange in 1, repair or reconstruction of collateral ligament with polyethylene exchange in 5, and revision with constrained or hinged implant in 3 when it was impossible to correct the imbalance of flexion-extension gap. All patients got stable knees and KSS functional and knee scores improved from average 55 and 56 points to 88.8 and 91 points respectively. Conclusion: Active repair or reconstruction of the ligament with polyethylene exchange wasone of the good options for treating instability after TKA. In cases of severe instability that could not be corrected by polyethylene exchange and repair or reconstruction of the ligament, revision with constrained or hinged implant was necessary.
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