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4개의 골수강내 금속정을 이용한 양측 유주 슬관절의 치료
문상호,정필현,채동주,배호균 대한골절학회 1999 대한골절학회지 Vol.12 No.2
The treatment of simultaneous ipsilateral femoral and tibial fractures is a challenging therapeutic problem. Unfortunately, despites a number of reports on these fractures, guidelines for treatment have not been well established. Because the knee joint is isolated partially or completely, the term $quot;floating knee$quot; is used. But most of these injuries are ipsilateral and few bilateral cases were reported in the literatures. The authors reviewed a case of bilateral floating knee treated by 4 intramedullary nails without having any prolonged healing time or limited range of motion in both knee joint postoperatively.
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정필현,황정수,강석,남기세,배호균 대한골절학회 1999 대한골절학회지 Vol.12 No.2
Fracture of the ankle is one of the most common fractures. Usually medial malleolar fractures, when non-displaced or minimally displaced, have been treated by closed reduction and cast immobilization for long period, so stiffness and osteoporosis of ankle were frequently inevitable. We investigated the result of percutaneous pinning or screw fixation and early mobilization in the treatment of medial malleolar fracture of the ankle. With clinical and radiological data, authors analysed 17 patients(17 ankles) who were treated with closed reduction and percutaneous pinning or screw fixation between August 1991 and May 1997. and following results were obtained. One case of pin site infection was noted and no nonunion or loss of fixation was identified and average duration of bone union was 12 weeks. According to Burwell's protocol, the good result are 16 cases, the fair is 1 case and the poor result is not observed. From the viewpoint of rehabilitation, authors consider percutaneuos pinning is an excellent plan of treatment of medial malleolar fractures, when non-displaced or minimally displaced.
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척추 유합술에서 자가 이식골과 동종 이식골의 비교 : 증례보고 A Case Report
정필현,김태훈,채동주,문상호,박윤근,배호균,이재학 東國大學校 1999 東國論叢 Vol.38 No.-
척추 유합술에 있어서 자가 골 이식이 가장 좋은 방법으로 알려져 있지만 수술 시간과 실혈량이 늘어나고 공여부의 통증 및 감염의 위험등 단점으로 동종 골 이식도 많이 사용되어지고 있다. 이러한 동종 이식골의 효용성에 대해서 많은 논란이 있어온 것은 사실이나 여러 변수들, 즉 나이, 성별, 흡연력, 수술의 종류등에 따른 영향을 완전히 배제시키지 못하여 순전히 동종 이식골과 자가 이식골간의 비교가 어려웠다. 저자들은 척추관 협착증으로 후방 감압술 및 후방 기기 고정술, 후외방 골 이식술을 받은 환자에게서 우측은 자가 이식골, 좌측은 동종이식골로 골 이식을 시행한 후 4년 추시에서 자가 골 이식한 부위는 견고한 골유합 소견을 보였으나 동종골 이식 부위는 이식 골이 모두 흡수되는 소견을 체험하여 같은 조건하에서 자가 이식골이 동종 이식골보다 골유합체의 형성에 있어서 더 우수하다고 생각한다. Posterior decompression, spinal instrumentation and bone grafting are the standard operative treatment method of spinal stenosis and other low back disorders. Although autograft bone is considered the standard in performing fusion of the bone, allografts are recommended as an alternative bone graft agent becaue of the lack of complications at the donor site such as infection, increased blood loss and prolonged operative time Autografts have the other limitations because of inadequate quality and quantity. Many investigators have compared autografts and allografts in posterior spinal fusion, and there are proponents as well as opponents of allograft use. Numerous factors are thought to affect fusion, including age, sex, nutritional status, associated disease, type of fusion, length of fusion, types of instrumentation and smoking status. The validity of comparison studies between allografts and autografts is questionable when these variables are not controlled. We describe a man who had a spinal stenosis at the level of L4-5 and L5-S1. He was operated with posterior decompression, spinal instrumentation and underwent a posterolateral bone graft, comparing autografts and allografts in the same patient. At 4-year follow up, autografts have a solid union but allografts are resorbed completely.
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