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송경원,박인헌,김갑래,이승용,현윤석,서은호,Song, Kyung-Won,Park, In-Heon,Kim, Gab-Lae,Lee, Seung-Yong,Hyun, Youn-Seok,Seo, Eun-Ho 대한족부족관절학회 2007 대한족부족관절학회지 Vol.11 No.1
Purpose: In this study, we introduced a newly developed technique of operation for hallux valgus. We used a single dorsal incision to correct major components of Bunion in stead of two or three incisions, which had been used by most of surgeons for long time. Materials and Methods: Between 2003 and 2005, 27 feet with hallux valgus deformity were operated through single dorsal incision. 10 out of 17 patients underwent operation on both feet, 5 patient underwent operation on left feet, remaining 2 underwent operation on right. There were 16 women and 1 man. Average age of patients was 45 (range, 21-59). Post operatively all feet were evaluated by physical examination, Maryland Foot score profile, radiographic measurements and complication. Results: Maryland foot score profile increased from preoperative 67/100 to postoperative 95/100. Most patients satisfied pain relieve and cosmesis. Average preoperative intermetatarsal angle was 15 degrees, which were decreased to 9 degrees after operation and average preoperative hallux valgus angle was 32 degrees, which were decreased to 12 degrees after operation. Conclusion: According to our experience, the single dorsal incision technic for correction of moderate to severe hallux valgus deformities was rather safe and easily performed without noticeable complication with almost same results as multiple incisions technics. We highly recommend this technic to be tried by foot surgeons without hesitation.
종골 골절의 제한적 후방 접근법 수술적 치료 후 조기 운동 및 재활 치료의 결과
송경원,김갑래,이진영,이광남,서은호,Song, Kyung-Won,Kim, Gab-Lae,Lee, Jin-Young,Lee, Kwang-Nam,Seo, Eun-Ho 대한족부족관절학회 2008 대한족부족관절학회지 Vol.12 No.1
Purpose: To evaluate the result of the early exercise and rehabilitation after limited posterior operative treatment of the calcaneal fractures. Materials and Methods: Between May 2005 and December 2007, 43 cases with intraarticular calcaneal fractures were treated by open reduction with K-wires and Steinmann pins. Mean age and mean follow-up period were 42.5 years old and 15 months. All patients were treated with the same postoperative protocol, the early exercise of subtalar joint without short leg splint and cast was began after postoperative 1 day, non-weight bearing crutch ambulation did after 2 weeks, partial-weight bearing crutch ambulation did after 6 weeks, without crutch ambulation did after 10 weeks. The fractures was classified by Essex-Lopresti and Sanders classification using radiographs and the functional outcomes were evaluated by circle draw exercise, AOFAS score. Results: By Essex-Lopresti classification, the tongue type was 6 cases (14%), the joint depression type was 15 cases (35%), the combined type was 22 cases (51%). By Sanders classification, type II were 10 cases (23%), type III were 15 cases (58%), and type IV were 8 cases (19%). By AOFAS functional evaluation, the mean preoperative scores were 70.3 and 70.5 respectively, mean postoperative scores were 83.7 and 86.9 respectively. There were satisfactory results in 40 cases but 3 cases were unsatisfactory including on case of lateral impingement and 2 cases of traumatic arthritis of subtalar joint. Conclusion: We obtained satisfactory result of the early exercise of subtalar joint without short leg splint and cast and rehabilitation after limited posterior operative treatment of the calcaneal fractures.
송경원,박인헌,신성일,이진영,문호동 대한척추외과학회 2001 대한척추외과학회지 Vol.8 No.1
연구계획 : 70세 이상의 고령에서의 경추성 척수증 환자의 수술적 결과에 대해 후향적 연구를 시행하였다. 목적 : 70세 이상의 경추성 척수증 환자에서 수술 후 임상결과 및 자기공명영상에서의 척수의 형태학적 변화를 비교 분석 하였다. 대상 및 방법 : 1988년부터 1997년까지 수술 받은 70세 이상의 환자 9예를 대상으로 하였으며, 술 수 신경손상 정도는 Japanese Orthopaedic Association(JOA) score로 평가하였으며 술 후 척수손상의 형태학적 변화는 자기공명영상을 기초로 하여 70세 이하의 군과 비교하였다. 결과 : 수술 전 JOA score는 평균 8.5였으며 수술 후에는 평균 12.8이었고 최대회복률은 51.1%로 70세 이하의 대조군에 비해 통계학적으로 유의하게 낮았다. 추시기간 후 JOA score는 11.3으로 낮았으며 회복률은 32.6%였으며 1예를 제외하고 대부분의 환자에서 일상생활 수행능력이 향상되었다. 술 후 자기공명영상에서의 형태학적 변화는 70세 이상에서 44%의 향상을 보였으며 70세 이하의 군에서 69%의향상을 보였다. 결론 : 고령의 환자에서도 신경기능의 향상 및 일상생활 수행능력의 향상을 위해 조기에 수술적 감압치료를 해주는 것이 환자에게 도움이 되리라 사료된다. Study Design : A retrospective study. Objectives : To evaluate the surgical outcomes and image by mid-sagittal MRI in patients with cervical myelopathy who were more than 70 years of age. Summary of literature Review : Surgical outcomes of cervical myelopathy in the elderly patients were worse than in the younger patients. but decompression surgery is helpful for improving neurologic function in the elderly. Materials and Methods : Nine patients more than 70 years of age who underwent surgery were reviewed. Neurologic deficits after surgery were assessed using a scoring system proposed by Japanese Orthopaedic Association(JOA) and clinical results and morphological changes on MRI were compared with those of patients less than 70 years old age. Results : The preoperative mean JOA score was 8.5 and the postoperative mean JOA score 12.8 and the maximum recovery rate was 51.1%, but these were significantly inferior to scores in those less than 70 years of age. At the time of final follow up, the mean JOA score had decreased 113 and the recovery rate was 32.60/0. All patients except one were improved their daily living function. On the postoperative midline T1 sagittal MRI. morphological improvement was seen in 44% in patients more than 70 years of age. while 69% of patients were improved in the control group. Conclusions : Surgical decompression appears to be necessary as soon as possible after the onset of progressive myelopathy in the elderly patients for improving neurologic function and ability to engage in daily living.