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서승석,김창완,김전교,진성엽 대한슬관절학회 2013 대한슬관절학회지 Vol.25 No.3
Purpose: To compare the clinical results of single-bundle anterior cruciate ligament (ACL) reconstruction using the conventional transtibial technique and the anatomical outside-in technique for femoral tunneling. Materials and Methods: From 2007 to 2011, 89 patients who received ACL reconstruction were followed for ≥1 year were enrolled in the study. The conventional transtibial technique was used in 41 patients and the outside-in technique, in 48 patients. Femoral tunnel angle measurement and three-dimensional computed tomography (3D CT) were used for radiologic assessment of the location of femoral tunnel and Lysholm score and other tests were used for clinical assessment. Results: Both techniques did not reveal statistical differences in the clinical assessment. However, in International Knee Documentation Committee subjective knee evaluation, the sum of two questionnaire items regarding instability showed a statistically significant difference (p=0.01). In the pivot shift test, the anatomical outside-in technique showed outstanding rotational stability over the transtibial technique (p=0.04). The mean femoral tunnel inclination in coronal plane were 69.2o and 30.3o, respectively, for both techniques, and 21.6o and 50.8o, respectively in sagittal plane, showing statistically significant differences on simple radiography (p=0.04, 0.05). A 3D CT was performed in 17 patients with the conventional transtibial technique and 25 patients with the outside-in technique. Coefficients of variation were 0.33 and 0.13, respectively, from dorsal border of the condyle and 0.67 and 0.24, respectively, from the roof of intercondylar notch. Conclusions: Femoral tunnels created with the outside-in technique have superior knee joint rotational stability compare to the transtibial technique. Therefore, the outside-in technique could be considered as a valuable technique in single-bundle ACL reconstruction.
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10년간 10, 11세 청소년에서의 특발성 척추 측만증 유병률 연구
안기찬(Ki Chan An),박대현(Dae Hyun Park),공규민(Gyu Min Kong),김주용(Joo Yong Kim),진성엽(Sung Yub Jin),이운성(Woon Seong Lee),김대유(Dae You Kim),하은정(Eun-Jung Ha),이규열(Kyu Yeol Lee),박원욱(Weon Wook Park),이정섭(Jung Sub Lee) 대한정형외과학회 2015 대한정형외과학회지 Vol.50 No.1
목적: 10년간 10, 11세 청소년을 대상으로 특발성 척추 측만증에 대한 학교 검진을 실시하여 유병률, 만곡의 크기, 유형 등에 대해 조사하였다. 대상 및 방법: 2002-2011년 동안 10, 11세 청소년 총 413,351명에 대해 선별검사로 모아레 검진법을 실시하였고, 선별된 피검자에 대해 단순 기립 척추 전장 방사선 사진을 촬영하였다. Cobb 각도 10o 이상을 측만증으로 판정하였으며 만곡의 크기, 위치 및 유형 등을 기록하였다. 결과: 10년간 전체 유병률은 평균 0.4% (0.3%-0.5%)였으며, 연도별 유병률은 큰 변화 추이가 없었다. 10년간 남녀의 유병률은 1.0:3.8이었으며 만곡의 크기는 10o-19o가 71%, 20o-29o가 24%, 30o-39o가 4%였다. Type III가 45%로 가장 많았고 type IV가 35%, type II가 11%, type I이 7% 및 type V가 5%로 조사되었다. 결론: 10, 11세 척추 측만증 유병률은 10년 동안 유사하였지만, 이전의 연구와는 차이를 보였다. 만곡의 크기, 위치 및 유형은 기존연구와 유사하였다. 기존 연구들과의 유병률의 차이는 선별검사가 원인으로 생각되며, 효과적인 선별검사에 대한 추가적인 연구가 필요하다. Purpose: School screening for adolescent idiopathic scoliosis (AIS) was conducted for 10 years and the prevalence of scoliosis as well as the size and types of curvature were investigated. The outcomes and existing research results were comparatively analyzed and the usefulness of the moire topography as a screening tool was evaluated. Materials and Methods: Moire topography was used in screening of 413,351 10- and 11-year-old from 2002 to 2011; simple standing entire spine x-rays of selected examinees were taken. When the Cobb angle was 10° or higher, the condition was deemed to be scoliosis, and the size, location, and types of curvature were recorded. Results: The average prevalence over the 10 years was 0.4% (0.3%-0.5%) and the trends in yearly prevalence did not change significantly. The ratio of boys-to-girls prevalence rates for the 10 years was 1.0:3.8. The rate of those with scoliosis whose curvature was 10°-19°, 20°-29°, and 30°-39° was 71%, 24%, and 4%, respectively. King-Moe type III accounted for the largest portion at 45%, followed by type IV at 35%, type II at 11%, type I at 7%, and type V at 5%. Conclusion: The prevalence of scoliosis in the subjects was similar for the 10 years but differed from previous research results. The size, location, and types of curvature were similar to those reported in previous research. The differences in prevalence from existing research are considered to be due to the screening method used. Therefore, conduction of additional research on effective screening tests is necessary.
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경피적 K-강선 고정술로 치료한 원위 요골 골절 -골다공증 유무에 따른 결과-
안기찬 ( Ki Chan An ),공규민 ( Gyu Min Kong ),최장석 ( Jang Seok Choi ),곽희철 ( Hi Chul Gwak ),김주용 ( Joo Yong Kim ),진성엽 ( Sung Yub Jin ) 대한골절학회 2013 대한골절학회지 Vol.26 No.4
목적: 원위 요골 골절에 대하여 K-강선 고정 시행 후, 골다공증 유무에 따른 결과를 분석하여 치료 방침 결정에 참고하고자 하였다. 대상 및 방법: 2007년 3월부터 2011년 2월까지 요골 골절로 비관혈적 정복 및 K-강선 고정술을 시행받고 6개월 이상 추시가능하였던 50세 이상 여성 57예에 대하여 T score -3 이상인 군(제1군)과 T score -3 미만인 군(제2군)으로 나누어 손목관절의 운동 범위와 Disabilities of the Arm, Shoulder and Hand (DASH) 점수를 비교하였고, 방사선학적으로 수술 직후 및 최종 추시의 요골 길이, 요골 경사, 수장부 경사의 변화를 측정하였다. 제1군은 34예로 나이는 평균 65.4 (50-78)세, T score는 평균 -1.97 (-0.1--2.93)이었고, 제2군은 23예로 나이는 평균 74 (54-89)세, T score는 평균 -4.11 (-3.1--6.97)이었다. 결과: 손목 관절의 운동 범위, DASH 점수, 요골 길이, 요골 경사, 수장측 경사의 차이는 제1군에서 나은 결과를 보였으나 통계적으로 유의한 차이는 없었다. 결론: 원위 요골골절의 치료에 있어 수장측 피질골의 분쇄가 없다면 골다공증이 동반되었더라도 경피적 핀 고정술이 가능할 것으로 판단된다. Purpose: To determine the influence of osteoporosis on the results of percutaneous K-wire fixation for distal radius fractures. Materials and Methods: Between March 2007 and February 2011, Fifty seven patients who underwent fixative surgery with K-wires after closed reduction and those available for follow-up for at least 6 months were reviewed. They were divided into the two groups of T score -3 or more (group 1) and T score less than -3 (group 2). These groups were compared by the range of motion of the wrist and Disabilities of the Arm, Shoulder and Hand (DASH) score. Radiologic evaluations consisting of radial length, radial inclination and volar tilt were compared. In group 1 with 34 cases, the average age was 65.4 years (50 to 78 years) and T score was -1.97 (-0.1 to -2.93). In group 2 with 23 cases, the average age was 74 years (54 to 89 years) and T score was -4.11 (-3.1 to -6.97). Results: There was no statistical difference between group 1 and group 2 in terms of range of motion, DASH score and radiologic evaluations. Conclusion: In the case of no volar side cortical comminution, percutaneous K-wire fixation can be applied for the treatment of distal radius fracture with osteoporosis.
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