목적: 이단계 수지 굴곡건 재건술과 수술 후 조기 병합 운동 요법을 시행한 환자들에 대한 추시 후의 기능적 결과 평가와 그 결과에 영향을 미치는 예후 인자에 대해 연구하고자 하였다. ...
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https://www.riss.kr/link?id=A76168385
2006
Korean
KCI등재
학술저널
19-27(9쪽)
0
0
상세조회0
다운로드국문 초록 (Abstract)
목적: 이단계 수지 굴곡건 재건술과 수술 후 조기 병합 운동 요법을 시행한 환자들에 대한 추시 후의 기능적 결과 평가와 그 결과에 영향을 미치는 예후 인자에 대해 연구하고자 하였다. ...
목적: 이단계 수지 굴곡건 재건술과 수술 후 조기 병합 운동 요법을 시행한 환자들에 대한 추시 후의 기능적 결과 평가와 그 결과에 영향을 미치는 예후 인자에 대해 연구하고자 하였다.
대상 및 방법: 진구성 수지 굴곡건 손상으로 이단계 수지 굴곡건 재건술을 시행 받았던 9예를 대상으로 하였다. 수술 전의 굴곡건 손상 정도는 modified Boyes’ classification에 의하여 1등급이 1예, 2등급이 5예, 3등급이 3예였다. 평균 추시 기간은 1년 8개월이었고, 최종 추시 결과의 판정 시 Buck-Gramcko score를 사용하였다.
결과: 최종 추시 결과 판정 시 수술 전 손상 정도가 3등급이었던 1예에서 양호였고 나머지 8예에서 우수였다. 손상에서 재건술 사이의 기간이 10년 이상 경과한 2예에서 우수의 결과를 보였고, 수술 전 수지 굴곡 구축으로 유리술을 시행하였던 3예에서 2예의 우수, 1예의 양호의 결과를 보였다. 활차 재건술이 시행된 5예에서 모두 우수의 결과를 보였다. 합병증으로 1예의 원위지부 감염, 1예의 건파열, 4예의 관절 굴곡 구축이 발생하였다.
결론: 이단계 수지 굴곡건 재건술과 수술 후 조기 병합 운동 요법은 파열되고 반흔 형성된 진구성 굴곡건 손상에서 수지 굴곡 기능을 회복시킬 수 있는 유용한 방법이라고 생각된다. 수술 후 조기 병합 운동 요법, 활차의 재건 및 보호, 굴곡 구축 유리술, 중등도 이하의 수술 전 손상 정도, 젊은 환자 연령층이 좋은 결과를 얻을 수 있었던 요인이었다고 생각된다.
다국어 초록 (Multilingual Abstract)
Purpose: To analyze the final results of a two-stage flexor tendon reconstruction in the hand with the early postoperative combined protocol of controlled motion, and to identify the prognostic factors associated with the final results. Materials a...
Purpose: To analyze the final results of a two-stage flexor tendon reconstruction in the hand with the early postoperative combined protocol of controlled motion, and to identify the prognostic factors associated with the final results.
Materials and Methods: Nine cases of two-stage flexor tendon reconstructions in 9 patients, who had been unable to flex their digits due to old flexor tendon injury, were examined. Using the modified Boyes' injury severity classification, the digits were classified as grades 1, 2 and 3 in 1, 5 and 3 patients, respectively. The average follow-up period was 1 year and 8 months and the final results are expressed using the Buck-Gramcko assessment system.
Results: Eight out of nine hands were graded as excellent and one patient whose injury severity had been graded 3 was graded as good. Excellent results were found in patients with a more than 10-year interval between the injury and the stage I procedure. Of the 3 patients who had undergone contracture release two were excellent and one was good. All 5 patients with a pulley reconstruction had excellent results. Complications involved one infection at the distal incision site, one tendon rupture and four flexion contractures.
Conclusion: A two-stage flexor tendon reconstruction with an early postoperative combined protocol of controlled motion is a useful procedure for restoring the flexor performance in old badly scarred digits. The excellent or good results might be due to following: the early protected rehabilitation incorporating two protocols, a pulley reconstruction and protection, flexion contracture release, an initial injury with less than moderate grade and the young age of the patients.
참고문헌 (Reference)
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1 MP Jr Coyle, "taged flexor tendon reconstruction fingertip to palm" 27 : 581-585, 2002
2 RM McCormack, "lexor- tendon grafts in the less-than-optimum situation" 44 : 1360-1364, 1932
3 RD Chuinard, "Two-stage superficialis tendon reconstruction in severely damaged fingers" 5 : 135-143, 1980
4 V Finsen, "Two-stage grafting of digital flexor tendons: a review of 43 patients after 3 to 15 years" 37 : 159-162, 2003
5 MA Wehbé, "Two-stage flexor-tendon reconstruction. Ten- year experience" 68 : 752-763, 1986
6 G Eskelend, "The ultrastructure of normal digital flexor tendon sheath and of the tissue formed around silicone and polyethylene implants in man" 59 : 206-212, 1977
7 A Chamay, "The two-stage graft. A salvage operation for the flexor apparatus. In: Verdan C ed. Tendon surgery of the hand. 1st" New York, Churchill Livingstone 109-112, 1979
8 LT Jr Furlow, "The role of tendon tissues in tendon healing" 57 : 39-49, 1976
9 CR Rayner, "The origin and nature of pseudo-synovium appearing around implanted silastic rods" 8 : 101-108, 1976
10 G Lundborg, "Superficial repair of severed flexor tendons in synovial envi- ronment. An experimental, ultrastructural study on cellular mechanisms" 5 : 451-461, 1980
11 JM Hunter, "Staged flexor tendon reconstruction" 8 : 789-793, 1983
12 KM Stewart, "Review and comparison of current trends in the postoperative management of tendon repair" 7 : 447-460, 1991
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19 JM Hunter, "Flexor-tendon reconstruction in severely damaged hands. A two-stage procedure using a silicone-dacron reinforced gliding prosthesis prior to tendon grafting" 53 : 829-858, 1971
20 B Jr Butler, "Flexor- tendon grafts in the severely scarred digit. An experimental study in dogs" 50 : 452-457, 1968
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24 NJ Barton, "Experimental study of optimal location of flexor tendon pulleys" 43 : 125-129, 1969
25 YC So, "Evaluation of results in flexor tendon repair: a critical analysis of five methods in ninety-five digits" 15 : 258-264, 1990
26 D Buck-Gramcko, "Evaluation criteria in follow-up studies of flexor tendon therapy" 8 : 65-69, 1976
27 H Becker, "Early active motion following a beveled technique of flexor tendon repair: report of fifty cases" 4 : 454-460, 1979
28 K Khan, "Early active mobilization after second stage flexor tendon grafts" 22 : 372-374, 1997
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자가 골수와 분쇄 동종골 혼합물의 경피적 주입술을 이용한 단순 골 낭종의 치료
학술지 이력
연월일 | 이력구분 | 이력상세 | 등재구분 |
---|---|---|---|
2026 | 평가예정 | 재인증평가 신청대상 (재인증) | |
2020-04-14 | 학회명변경 | 영문명 : 미등록 -> The Korean Orthopaedic Association | |
2020-01-01 | 평가 | 등재학술지 유지 (재인증) | |
2017-01-01 | 평가 | 등재학술지 유지 (계속평가) | |
2014-01-14 | 학술지명변경 | 외국어명 : 미등록 -> Journal of the Korean Orthopaedic Association | |
2013-01-01 | 평가 | 등재학술지 유지 (등재유지) | |
2010-01-01 | 평가 | 등재 1차 FAIL (등재유지) | |
2008-01-01 | 평가 | 등재학술지 유지 (등재유지) | |
2005-05-30 | 학술지등록 | 한글명 : 대한정형외과학회지외국어명 : 미등록 | |
2005-01-01 | 평가 | 등재학술지 선정 (등재후보2차) | |
2004-01-01 | 평가 | 등재후보 1차 PASS (등재후보1차) | |
2002-07-01 | 평가 | 등재후보학술지 선정 (신규평가) |
학술지 인용정보
기준연도 | WOS-KCI 통합IF(2년) | KCIF(2년) | KCIF(3년) |
---|---|---|---|
2016 | 0.06 | 0.06 | 0.08 |
KCIF(4년) | KCIF(5년) | 중심성지수(3년) | 즉시성지수 |
0.08 | 0.08 | 0.24 | 0.01 |