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척추 유합술시 시행한 수술 전 혈액예치식 자가 헌혈의 유용성
손훈상,이환모,이성실,김현옥 대한수혈학회 2010 大韓輸血學會誌 Vol.21 No.1
Background: Major orthopedic surgical procedures, including spinal fusions, require 2 or 3 units of transfusion. In this study, we evaluated the usefulness of autologous transfusion by comparing the postoperative infections, the pre- and postoperative serological changes, the amount of transfusion during the operation and the segmented estimated blood loss of the patients who received spinal fusion surgery. Methods: We analyzed 106 patients who were undergoing spinal fusion surgery and among them, 69 patients were operated on with using autologous transfusion, while 37 cases were operated on with using homologous transfusion. Results: The segmental estimated blood loss was approximately 574.4±131.8 mL in group 1 and 635.3±250.1 mL in group 2. The mean number of transfused units in the autologous transfusion group was 2.1±0.3 units and this was 3.5±0.6 units in the homologous transfusion group. There was no significant statistical difference in the hemoglobin level or the complications between the two groups, yet the duration of fever in the group with homologous transfusion was 3.0±0.4 days, which was increased compared to that of group 1 (1.4±1.3 days). Conclusion: The total amount of transfusion and blood loss for the patients who were operated on using autologous transfusion were less, as compared to those for the patients who were operated on with homologous transfusion, and the patients with homologous transfusion showed a significantly decreased duration of fever. It seems that autologous transfusion is a way to shorten the duration of fever and increase the satisfaction of the patients. (Korean J Blood Transfus 2010;21:50-57) 배경: 수술 전 혈액 예치에 의한 자가 수혈은 척추 유합술처럼 2∼3단위 이상의 수혈을 요할 경우 쓰일 수 있다. 저자들은 척추 유합술을 시행 받은 환자에서 수술 전 혈액 예치식 자가 수혈만을 시행한 환자들과 동종 혈액만을 수혈 받은 환자들의 술 후 감염, 술 전과 술 후의 혈액학적 변화, 수술시 출혈량 및 총 수혈량 등을 비교하여 자가 수혈의 유용성을 평가하고자 하였다. 방법: 척추 유합술을 시행 받은 환자 중 자가 수혈만 받은 69예와 동종 수혈 만을 받은 37예를 대상으로 총 106명의 환자에 대해 분석하였다. 자가 수혈 피험자의 선정기준은 혈색소치가 11 g/dL 이상인 환자로 제한하였으며 체중, 수술 전 혈압 및 맥박을 검사하여 선정 기준에 맞는 환자를 대상으로 하였다. 결과: 척추 유합술시 분절 출혈량은 자가 수혈군에서 약 574.4±131.8 mL였고 동종 수혈군에서 약 635.3±250.1 mL였다. 총 수혈량에 있어서 자가 수혈군에서의 평균 수혈량은 2.1±0.3단위였으며 동종 수혈군에서는 3.5±0.6단위로 자가 수혈군이 동종 수혈군에 비해 혈액 사용이 통계학적으로 유의하게 적었다. 합병증의 발병 역시 양 군간에 통계학적 차이는 없었으나 발열 기간에 있어서는 동종 수혈군에서 3.0±0.5일로 자가 수혈군의 1.4± 1.3에 비해서 더 증가된 수치를 나타내었다. 결론: 척추 유합술 시 자가 수혈을 시행 받은 환자는 동종 수혈을 시행 받은 환자에 비해 총 수혈량이 적었으며 전신 발열 기간에서도 의미있는 감소하는 장점이 있어 그 영역을 보다 확대할 수 있을 것이다.
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상완골 소결절에 발생한 부정 유합의 관절경적 치료 - 증례 보고 -
손훈상,정덕문,신상진,Sohn, Hoon-Sang,Chung, Duk-Moon,Shin, Sang-Jin 대한관절경학회 2008 대한관절경학회지 Vol.12 No.3
Coracoid impingement syndrome results from abnormal contact between the anterosuperior humerus and the coracoacromial arch. The coracoid impingement may occur from traumatic, idiopathic, or iatrogenic causes. Traumatic causes of coracoid impingement include fractures of scapular neck, coracoid process or lesser tuberosity. Coracoid impingement due to lesser tuberosity malunion is a rare disease and most of them were treated by open procedures. The authors present a case of coracoid impingement caused by malunion after isolated lesser tuberosity fracture which was treated by arthroscopic coracoplasty with percutaneous screw fixation.
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불안정성 쇄골 원위부 골절에 대한 Hook 금속판 고정술의 치료 결과
손훈상 ( Hoon Sang Sohn ),조병철 ( Byung Chul Jo ) 대한골절학회 2011 대한골절학회지 Vol.24 No.4
Purpose: This study evaluated the clinical and radiological outcomes of unstable distal clavicular fractures treated with an AO Hook plate. Materials and Methods: From March 2009 to October 2010, sixteen patients with distal clavicular fractures underwent open plating using an AO Hook plate. The clinical outcomes were assessed by measuring the UCLA scores and KSS sores, and the radiological outcomes were evaluated using simple radiographs at the final follow-up. Results: Fracture union was obtained in all patients at an average of 13.9 weeks (range, 9~20 weeks). The UCLA scoring system showed excellent results in 9 cases and good results in 7. The average KSS scores of distal clavicular fractures were 95.5. At the final follow-up, subacromial osteolysis developed in 11 cases (68.7%) of whom 3 suffered from pain around the acromion. Other complications occurred in 4 patients: one had a fracture adjacent to the plate proximally, two had a stiff shoulder with subacromial impingement, and one had hypoesthesia around the surgical wound. Conclusion: Unstable distal clavicular fractures treated with a Hook plate provided rigid fixation and satisfactory outcomes considering the high union rate. Nevertheless, potential postoperative complications related to morphometric properties of the plate should be considered.
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동측 쇄골의 내측 및 외측 동시 골절: 이중 쇄골 골절 - 증례 보고 -
박경준,손훈상,백경영 대한골절학회 2011 대한골절학회지 Vol.24 No.1
쇄골 골절은 임상에서 흔히 접할 수 있는 상지 손상의 하나이나, 동측 쇄골의 내측, 외측 혹은 간부 골절이 동시에 일어나는 경우는 매우 드물다. 현재까지 전세계적으로 7예가 보고되고 있으나, 국내에서는 보고된 바가 없다. 이에 저자들은 낙상 후 발생한 쇄골 외측 골절과 동반된 쇄골 내측 골절 1예를 경험하였기에 문헌 고찰과 함께 손상 기전과 진단 및 치료에 대해 보고하고자 한다.
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대퇴골 두 골절의 조기 합병증 발생에 영향을 미치는 위험인자
정회정,이진우,이동우,손훈상 대한골절학회 2020 대한골절학회지 Vol.33 No.4
Purpose: This study analyzed the prognostic factors in patients with femoral head fractures by comparing two groups with and without complications. Materials and Methods: A retrospective study was performed on femoral head fracture patients who visited two different level-1 trauma centers from January 1, 2014 to June 30, 2018. Thirty-three patients with a follow-up period of more than one year were included. Early complications were defined as fair or poor in the Thompson–Epstein clinical evaluation criteria and grades 3 or 4 in the Kellgren– Lawrence classification within one year after the fracture. The patients were divided into two groups, with and without early complications. Statistical analysis was performed for the nominal variables with a Fisher’s exact test and continuous variables using a Mann–Whitney U test. Results: Nine patients (27.3%) had early complications, and there were no significant differences according to age, sex, treatment method, combined fractures, Pipkin classification, and AO/OTA classification between the two groups. Conclusion: The prognosis in femoral head fractures is difficult to predict. Therefore, the validation of existing classifications or a new classification is necessary.
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