전방십자인대 손상의 진단

인주철 대한슬관절학회 1989 대한슬관절학회지 Vol.1 No.1

In evaluating anterior cruciate ligament injuries, we need a sound understanding of the functional anatomy combined with a careful history and physical examination. Diagnosis of anterior cruciate ligament injury may be made with a combination of tests. Standard roentgenograms and arthrography play a role in evaluation of injury, but the role of arthroscopic diagnosis has increased recently.

食鹽水 또는 蒸溜水投與가 副腎皮質에 미치는 影響에 關한 電子顯微鏡的 硏究

印柱哲,洪錫宰 慶北大學校 醫科大學 1972 慶北醫大雜誌 Vol.13 No.2

슬관절 인대손상의 임상진단

인주철 대한가정의학회 1984 Korean Journal of Family Medicine Vol.5 No.6

저온열 자가골 처리시 골내부로의 열전달에 관한 실험적 연구

인주철,박일형,김신윤,김신근 慶北大學校 醫科大學 1994 慶北醫大誌 Vol.35 No.1

목적 : 사지골에 악성종양이 발생하였를 때 절단하지 않고 사지구제술이 많이 적용되고 있는바, 이중한 방법으로 이완된 골을 광범위 절제후 열처리하여 재삽입하는 방법이 이용되고 있다. 이는 종양세포를 기사 시키면서 골의 강도를 유지해야 하며 가능한한 낮은 온도에서 열처리하는 것이 골의 강도를 유지할수 있는 좋은 방법이다. 이에 저자들은 저온 열처리시에 주로 이용되는 60℃, 80℃ 및 100℃ 조건에서 어느 정도 시간이 경과하면 골 내부까지 충분히 열이 전달 되는지를 측정하기 위해 본 연구를 시행하였다. 대상 및 방법 : 인체골과 유사한 돼지경골 및 대퇴골에서 중심부위(가장 온도가 천천히 올라가는 부위)를 찾아내고 이것을 기준으로 인체의 근위경골 3개와 원위 대퇴골 2개에 중심부위까지 열감지기를 삽입후 60℃, 80℃ 및 100℃의 항온조에 침잠시켜 상온인 25℃에서 종양의 불활성 온도인 43℃까지 상승하는데 걸리는 시간을 측정하였다. 결과 : 1. 60℃에서 골의 중심온도가 25℃에서 종양괴사 온도로 알려진 43℃에 이르는 시간은 원위 대퇴골에서 470초, 근위경골에서 610초가 소요되었고, 80℃에서는 원위 대퇴골에서 280초가 근위경골에서 380초가 소요되었다. 2. 근위경골이 원위대퇴골 보다 열전달이 지연되었다. 3. 골중심온도(core temperature)가 외부 식염수온도와 같아지는 데는 식염수의 온도와 큰 상관없이 30분이상 소요되었다. 4. 골형성골육종이 있는 골에서는 열전달 속도가 정상골 보다 지연되었다. 결론 : 대부분 80℃ 정도에서 10∼15분 정도 자가소독해서 사지구제술에 이용하고 있지만 본 실험에서는 경골 근위부에서 60℃에서 610±180초, 80℃에서는 380±180초 동안 뼈를 가열하면 골괴사를 시킬 수 있는 시간임을 알아내었고 임상에서 인체골 조직을 자가소독해서 적용할 때 이에 대한 지표로 사용할 수 있다고 사료되었다. In countries where Confucianism is popular, it is extremely hard to get fresh cadaver bone for allograft. Therefore in Korea, the reimplantation of resected autoclaved autogenous bone segments has been increasingly performed for limb reconstruction of extremities with malignancies. To preserve the bone morphogenetic protein and mechanical strength of heated bone, many studies have reported that pasteurization of bone is far better than autoclaving over 100℃- Based on this assumption, replacement with a pasteruized autogenous bone graft after resection of a malignant bone tumor was deemed feasible for reconstruction. However, little is known about how high a temperature and how much time for pasteurization is needed to make tumors completely necrotic and to maintatin the mechanical strength of bone. Consequently, experimental studies were carried out to test heat conductivity of human bone and torsional strength of porcine tibia after pasteurization. Two pairs of human proximal tibia and distal femur were used. We used T-type thermocouples to check core temperature of the bone and a computerized data acquisition system to record results. Without reaming of the medullary cavity, in a 60℃-thermostatic saline tub, it took 32 minutes and 50 seconds to raise the core temperature of human proximal tibia from 20℃ to 58℃, and 30 minutes for distal femur. In a 80℃ saline tub, it took 12 minutes and 50 seconds for proximal tibia, and 11 minutes and 10 seconds for distal femur. In contrast, using procine tibia whose cortical thickness is similar to that of human tibia, after reaming of the medullary canal, it took less than 3 minutes and 30 seconds in a 60℃ saline tub, less than 1 minute and 45 seconds in a 70℃ tub, and less than 1 minute in a 80℃ tub to elevate core temperature from 20℃ to 58℃.

슬관절 관절경

인주철 영남대학교 의과대학 1984 Yeungnam University Journal of Medicine Vol.1 No.1

胸部 X-線 深部照射가 遠隔臟器에 미치는 影響에 關한 病理組織學的 檢索

印柱哲 慶北大學校 醫科大學 1970 慶北醫大雜誌 Vol.11 No.2

고관절 후방 탈구를 동반한 대퇴 골두골절

인주철,김풍택,양동렬,김신윤 대한골절학회 1994 대한골절학회지 Vol.7 No.2

We analyzed Twenty eight cases of femoral head fracture associated with posterior hip dislocation managed in Kyungpook National University Hospital between 1984 march and 1993 June. Classification was made by Pipkin and we added impaction fracture as another classification by post reduction CT finding. The results were as follows 1. Most common type of fracture was impaction of femoral head by CT, Which is not included by pipkin classification. 2. Excellent, or Good result according to Epstein criteria, 7 of 8 cases in Pipkin type [, 1 of 3 cases in type II, 0 of 4 cases in type 0, 1 of 4 cases in type N, 6 of 9 cases in impaction fracture. 3. There were no significant difference between the results of operative treatment and conservative treatment. 4. Post reduction CT was useful to determine the method of the further treatment. 5. Complications were avascular necrosis in 5 cases, posttrumatic arthritis in 3 cases, sciatic nerve paresis in 2 cases, heterotropic ossification in 1 case.

새로운 형태의 Electrogoniometer 를 이용한 동적상태에서의 슬관절 삼차원 운동범위 측정

인주철,김신윤,김규산,김영은,안정호 ( Joo Chul Ihn,Shin Youn Kim,Kyu San Kim,Yung Eun Kim,Jeong Ho Ahn ) 대한슬관절학회 1993 대한슬관절학회지 Vol.5 No.2

The movements of the knee joint are very intimately influenced by the movement of other joints of the leg. The functional interpretations of the movements of the knee joint are very important, recognized as practical problems, and there are a lot of difficulties in measuring the movements of the knee joint accurately, especially when there is instability of the knee joint. Many researches have been made to measure the 3-dimensiona1 rnovements of the knee jaint quantitatively and high speed stereo photographic method,video camera method, method using the accelerator, electrooptical method and methods using the exoskeletal link system are introduced so far. However, these methods are so complicated and have shortcomings that there is no way to correct the errors. So we performed this research to develop a new elec- trogoniometer which is easy to correct the errors and simple in deisgn. The new instrument used in this research is composed of two universal joints and a pin joint between them, and 6 electrogoniometers are applied to measure the relative 3-dinen- sional positions of the moving tibia compared with fixed femur, The results were as follows. The amount of knee motion on flexion/extension plane were ranged from the minimum of 42.11 to the maximum of 72.12, and the mean value was 55.02'. The amount of rotation were ranged from 9.98 to 17.21, mean value was 13.07. The amount of knee motion on adduction/abduction were from 9,74 to 15.91, mean value was 12.01

십자인대 손상시 인조인대 재건술후 기능적 평가

인주철,박병철,김신윤,박재현 ( Joo Chul Ihn,Byung Chul Park,Shin Yoon Kim,Jae Hyun Park ) 대한슬관절학회 1993 대한슬관절학회지 Vol.5 No.2

The principle of treatment in rupture of cruciate ligaments, whether conserva- tive or operative, is difficult and still controversial. Authors studied 20 patients from January 1989 to December 1991, we reconstructed 31 ruptures of cruciate ligaments using polyethyleneterephtalate artificial ligament (Trevira), In this study only 20 patients who we could long term follow up were participated. The average follow up period was 20.7 months with maximum 29 months and minimum 7 months. We evaluated the patients by radiologic finding (drawer test), clinical finding (Lysholm knee scoring scale) and stability using knee ligament arthrometer (KT2000). The results were excellent 1 case, good 11 cases, fair 7 cases, poor 1 case by Lysholm knee scoring scale and the mean displacements were 9.2 mm (ACL), 11.7 mm (PCL) in preoperative, 4.2 mm (ACL), 6.8 mm (PCL) in follow up by stress X-ray. The mean displacements were 2.3 mm (15 lb), 3.1 mm (20 lb), 4.0 mm (30 lb) in nor- mal side, 4.3 mm (15 1b), 6.3 mm (20 1b), 8.5 mm (30 1b) in affected side and the mean difference of displacements were 2,0 mm (15 lb), 3.2 mm (20 Ib), 4.5 mn (30 lb) in ACL and the mean displacement was 2,2 mm (20 lb) in normal side, 3.2 mm (20 lb) in affected side and the mean difference of displacement was 1.0 mm (20 lb) in PCL by arthrometer.

슬개골 골절 후 속발한 슬관절 강직에 대한 대퇴 사두고근 성형술 및 관절 유리술

인주철,경희수,이상국 ( Joo Chul Ihn,Hee Soo Kyung,Saeng Guk Lee ) 대한슬관절학회 1995 대한슬관절학회지 Vol.7 No.1

Quadricepsplasty and arthrolysis are techniques devised to release extra-articular adhesions or contractures which are caused by injuries around the knees leading to fibrosis and scamng of all or part of the quadriceps. Since the earliest description of lengthening of the quadriceps tendon hy Bennet(1992), several reports have been made by Thompson(1994), Judet(19S9), van Nes(1962). Nicoll(196.3), k3esketh(I 9ti3) and Daoud(1982). The authors analyzed the results of the Judet's quardricepsplasty and arthrolysis which were done f'rom June 1990 to October 1993 in stiff knees following patellar fractures. Among 11 cases, 9 cases of the patients were followed up for average 22.6 months. The results v ere as follows. 1. Of 9 cases, 7 cases were men and 2 cases were women. 2. Age ranged from 20 to 54 average being 38 years old. 3. Average tollow up period was 22.6 months ranging from l2 months to 48 months. 4. The initial injuries were femoral fractures with patellar fractures in 7 cases and patellar f'ractures in 2 cases. S. The rnean preoperative range of motion was from 8.9 degrees of tlexion contracture to 46.1 degrees ot' further flexion and at the most recent follow up, the mean range of nx>tion was from S.S degrees to 104A degrees. So flexion gain was 58.3 degrees and extension gain was 3.4 degrecs on the average. 6. By Judet's criteria of evaluation 6 cases(67%) showed excellent result and 3 cases(33%) showed fair. 7. The pate,llar fracture seems to he one of the causes of stiff knee and the result was less favorable in the stiff knees with connuted patellar fractures. And it is difficult to treat stiff knee, if intra-articular adhesions cannot be released by arthrolysis.