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羅相淵,尹承鎬 충남대학교 의과대학 지역사회의학연구소 1985 충남의대잡지 Vol.12 No.1
In the management of the congenital dislocation of the hip, early diagnosis and treatment is far most important and the key point for obtaining good results. Even in the older age group, results have been improved by nearly reported methods. But until now, there is no one fully accepted guide for the treatment of the congenital dislocation of the hip. Authors studies 25 cases in 24 patients with congenital dislocation of the hip at the Department of Orthopedic Surgery, Chungnam National University Hospital during a 6 year period from January, 1976 until December, 1982. The results were as follows : 1. In the group of patients before 1 1/2 year of age, closed reduction were done, with 85.7%, and 100% excellent and good results respectively (group 1). 2. In the group of patients treated between 1 1/2 and 3 years of age, closed reduction, open reduction, and Salter's innominate osteotomy with open reduction were done, with 50.0%, 66.7% and 100% excellent and good results respectively (group 2). 3. In the group of patients treated between 3 and 6 years, open reduction, and Salter's innominate osteotomy with open reduction were done, with 50.0% and 66.7% excellent and good results respectvely (group 3). 4. In the patients treated by the method of closed reduction, in the group 1, and the group 2 of age, with 85.7%, 50.0% excellent and good results respectively. In the patients treated by method of open dreuction, in the group 1, and the group 2, and the group 3 of age were done, 100%, 66.7%, 50.0% excellent and good results respectively. In the patients treated by method of Salter's innominate osteotomy with open reduction, in the group 2 and the group 3 of age were done, with 100%, and 66.7% of age excellent and good results respectively. The younger age of patients in this study, the better results of various treatments were noted. 5. We correlated the incidence of femoral head necrosis with the `hip station' just before reduction according to Gage and Winter's classification. Four of the 5 hip in minus-one station developed necrosis (80.0%), 3 of 9 hips in zero station had necrosis (33.3%), and only 2 of the 11 hip in plus-one station had necrosis (17.2%). Femoral head necrosis was severe in all 4 hips with necrosis in miuns-one station. Of the 3 hips with necrosis in zero station, 2 had severe necrosis and one had mild necrosis. Of the 2 hips with necrosis in plus-one station, 1 had severe necrosis and one had mild necrosis. None of the patients with femoral head necrosis had a perfect anatomical result. 6. The incidence of femoral head necrosis by the type of reduction, closed reduction, open reduction, and Salter's innominate osteotomy with open reduction were done with 45.4%, 33.3% and 20.2% results respectively. There is in agreement with reports of a generally lower incidence of avascular necrosis after open reduction. 7. The patients immobilized in the Lorenz position had highest incidence of avascular necrosis and there was a greatly reduced. incidence if patients was immobilized in the Lange or human position. 8. Redislocation of the femoral head occured only in 2 cases of our patients. One case immobilized in the Lange position, the other immobilized in the Lorenz position was noted. 9. In the older age group (between 8 and 14 years), 2 cases of Chiari osteotomy, 1 case of Klisic operation, only one case treated Chiari osteotomy achieved good result.
이준규,나상연 충남대학교 의과대학 지역사회의학연구소 1984 충남의대잡지 Vol.11 No.2
Many different methods have been tried for the treatment of fractures of the calcaneus in order to search for better results. But there is no general agreement on the treatment of the fracture of the calcaneus, especially involving the subtalar joint. Calcaneal fractures of 39 feet in 31 patients which were treated at the Dept. of Orthopedic Surgery, Chungnam National University Hospital since 1976 to 1982 were clinically analyzed, and the following results were obtained. 1. Of 31 patients, 25 patients were male and 6 were female. Their ages ranged 9 to 61 years and averaged 33 years. 2. The main cause of fracture of calcaneus was a fall from a height in 77.4% of cases, and the spine fractures were associated in 9 patients with calcaneal fractures. 3. Fractures involving the subtalar joint were 29 feet (74.4%) and Rowe's type 5 were 19 feet(48.7%). 4. Rowe's type 1. 2. 3 and 4 types (20 cases) were treated by only conservative method, and of Rowe's type 5 fractures (19 cases), 15 fractures were treated conservatively and 4 fractures were treated operatively. And then favorable results were obtained. 5. The most common complication after treatment was pain on the heel and around the ankle joint.
대퇴골 경부골절과 SINGH 지수와의 연관성에 대한 임상적 고찰
윤승호,안상로,나상연,정태성 충남대학교 의과대학 지역사회의학연구소 1986 충남의대잡지 Vol.13 No.1
The Singh index have been used widly for measuring degree of osteoporosis which was the important cause of the femoral neck fracture because of the adventage as noninvasive, simple, good reproducible and index of general osteoporosis. The purpose of this article is to study the clinical significance of the Singh index. For the this purpose, the fractured groups of 71 patients older than 45 years of age with femoral neck fracture who were admitted in department of orthopedic surgery, Chungnam National University Hospital from March, 1980 to Feb., 1985 in contrast to control group without fracture were measured Singh index, analysed the relationship between Singh index and patient's age, type of femoral neck fracture and degree of trauma. Following results were obtained. 1. The average age is 66 years old in fractured group and is 60.16 years old in control group. The average Singh index of fractured group is 3.23 and is 4.27 in control group. There is a statistically significant difference between fractured and control group by 1.04 (p<0.05). 2. The average Singh index below 54 years old is 4.933, the prevalence of definite osteoporosis (Grade Ⅰ, Ⅱ) is 6.7%, but the average Singh index above 75 years old is 2.32, the prevalence of definite osteoposis was 52%. 3. The average Singh index of the intracapsular and extracapsular fracture of femoral neck fracture is 3.47 and 3.05. There is no statistically significant difference (p<0.1). 4. The average Singh index of the Mild trauma group and Severe trauma group is each 2.5 and 4.28. There is statistically significant difference (p<0.01). 5. Statistically the prevalence of Severe trauma in men(60%) is higher than in women(22%).