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굴곡구축을 동반한 슬관절에서 후방 십자 인대 보존형 슬관절 전치환술의 결과 : 후방 안정형과의 비교 In Comparison with Posterior Stabilized Type
김용훈,김근우,민학진,윤의성,김상림,김윤종 대한슬관절학회 2001 대한슬관절학회지 Vol.13 No.2
목적 : 심한 굴곡구축 변형을 동반한 슬관절에서 후방 십자 인대 보존형을 주로 사용하여 슬관절 전치환술을 시행하고 이를 같은 시기에 후방십자 인대를 절제하고 후방 안정형을 사용하여 치료한 예와 술후 슬관절의 임상적 결과를 비교하고자 하였다. 대상 및 방법 : 1994년 4월부터 2000년 6월까지 슬관절 전치환술을 시행받은 환자중 슬전 굴곡구축이 15도 이상이고 후방 십자 인대 보존형을 사용한 63명 73 슬관절을 Ⅰ군, 굴곡구축 15도 이상이고 후방 십자 인대 제거하고 후방 안정형을 사용한 16명 16관절을 Ⅱ군으로 분류하고 이를 대상으로 수술전 및 술후 잔여 굴곡구축과 임상적 평가를 시행하였다. 결과 : 최종 추시시의 잔여굴곡구축(Ⅰ군: 4.3±6.5도 Ⅱ군: 4.5±2.8도), HSS 슬관절 평가지수(Ⅰ군: 94.9±5.1 Ⅱ군: 93.0±5.4), TKSCRS 평가지수(Ⅰ군: 162.0±13.0 Ⅱ군: 163.7±12.2)는 두 군간의 유의한 차이가 없었다(p>0.05). 결론 : 슬관절 굴곡구축이 심한 경우에 일반적으로 후방 안정형을 사용하나 후방 십자 인대 보존형(Ⅰ군)을 사용한 경우에도 후방 안정형을 사용한 경우(Ⅱ군)에 비해 결과에 유의한 차이가 없었다. Purpose : To evaluate the clinical results of cruciate retaining type total knee arthroplasty in patients with severe flexion deformity by comparison with that of posterior stabilized type. Materials and Methods : From April 1994 to June 2000, 73 cases(63 patients) with preoperative flexion deformity over 15 degrees who underwent cruciate retaining type were categorized as group Ⅰ. 16 cases(16 patients) who underwent posterior stabilized type were categorized as group Ⅱ. We analyzed clinical results according to residual flexion deformity and knee functional score. Results : There was no statistically significant difference in residual flexion deformity(Ⅰ: 4.3±6.5 degree, Ⅱ: 4.5±2.8 degree), HSS knee score(Ⅰ: 94.9±5.1, Ⅱ: 93.0±5.4), TKSCRS score(Ⅰ: 162.0±13.0, Ⅱ: 163.7±12.2) between two groups(p>0.05). Conclusion : Usually in severe flexion deformity patients, posterior stabilized design has been used, but our results show no significant statistical difference between cruciate retaining type and posterior stabilized type.
대퇴 골수강 내에 남겨진 수술 기구 부위에 발생한 대퇴 스템 주위 골절 - 증례 보고 -
김용훈,김근우,이민섭,김상림,민학진,조국형,윤의성 대한골절학회 2000 대한골절학회지 Vol.13 No.2
Postoperative periprosthetic fracture of the femur after hip arthroplasty is a serious complication that can be difficult to treat. Moreover, it has become more common in recent years, as the cases of hip arthroplasty and revisional hip arthroplasty increase. We have experienced a postoperative periprosthetic fracture of the femur probably caused by a surgical instrument left in the medullary canal during hip arthroplasty. We report this case with reference to other related articles.
골다공증을 동반한 60세 이상 골절의 복합 고정에 의한 치료
김용훈,김근우,김희오,김상림,민학진,윤의성,김윤종,유기찬,안영준 대한골절학회 2001 대한골절학회지 Vol.14 No.1
Purpose: This study summarizes the satisfactory results obtained using a composite fixation method for the surgical treatment of long bone fractures in elderly patients with osteoporosis. Materials and Methods: We reviewed 10 cases of long bone fractures, that were treated by composite fixation, involving patients over 60 years of age that presented with radiological osteoporosis. Composite fixation was applied incorporating, traditional plate and screw fixation in conjunction with bone graft, plate or intramedullary bone cement at four cases of humeral shaft fractures, three cases of femur supracondylar fractures, two cases of femur shaft fractures, and one case of tibia shaft fracture. Results were evaluated in methods of ambulation, range of motion, bony union and complications Results: Satisfactory ambulation and range of motion was observed in all cases, which showed bony union without early implant failure. No re-operation were necessary due to nonunion. No medical complication was noted. Conclusion: The results shows that the composite fixation method provided a stable reduction and a rigid fixation, which facilitated bony union, and allowed elderly patients with osteoporosis an early range of motion and mobility after the surgical treatment of long bone fractures.
요골 간부 골절에 동반된 동측 요골 골두부의 탈구 - 증례보고 -
김재희,김용훈,김근우,김희오,민학진,윤의성 대한골절학회 2000 대한골절학회지 Vol.13 No.3
Radial head dislocation with ipsilateral radial shaft fracture is one of the reportable trauma case with very low incidence. Only 4 cases of this type injury have been reported worldwide. In 3 cases of them, good results were achieved after early closed reduction of the radial head, followed by internal fixation of the radial shaft. In the authors' case, the patient received the same method of treatment mentioned at the previous successful 3 cases. But after that, he suffered from repeated dislocations and finally nonunion of the fracture. At last, the authors could obtain bony nuion and stable elbow joint after radial head resection and osteosynthesis using autologous cancellous bone graft, but resulted in limitation of motion. We report the case and the experience of treatment.