• Title/Summary/Keyword: 경골 근위부

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Treatment of Tibial Fractures by Interlocking Intramedullary Nailing (Interlocking Intramedullary Nail을 이용한 경골 골절의 치료)

  • Jung, Kwang-Yeoung;Lee, Dong-Chul;Suh, Jae-Sung;Kim, Se-Dong
    • Journal of Yeungnam Medical Science
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    • v.10 no.2
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    • pp.388-399
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    • 1993
  • The adequate treatment of tibia fracture is one of the most difficult due to severe commiuntion, open wound, delayed union, angulation deformity and infection. We treated 38 fractures of the tibia by Interlocking intramedullary nail from Feb. 1983 to Mar. 1993, 35 cases of the tibia fracture were fresh, 13 cases of fracture were open. The other 3 cases were delayed union and nonunion. The Mean follow-up was 14.0 months. The results were as followings. 1. Of the 38 fractures, 37 fractures united and the mean union time was 18.7 weeks. 2. Interlocking intramedullary nail could be used to the majority of fractures of the proximal & distal tibia shaft fractures. 3. The Interlocking nail had rigid rotational stability and was appropriate for the treatment in severe unstable fractures, commninution and open with bone loss. 4. Delayed union or nonunion was a good indication for intramedullary nailling. 5. The major complication were valgus deformity of 2 cases, varus deformity of 1 case, 1 case deep infection. 6. Interlocking intramedullary nailing provided rigid fixation of fracture and then made early joint motion exercise and ambulation.

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An immunohistochemical study of endocrine cells in the gut of the Prussian carp, Carassius auratus (붕어(Carassius auratus) 장 내분비세포에 관한 면역조직화학적 연구)

  • Lee, Hyeung-Sik;Ku, Sae-Kwang;Park, Gi-Dae;Lee, Jae-Hyun
    • Korean Journal of Veterinary Research
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    • v.41 no.4
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    • pp.477-484
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    • 2001
  • The regional distribution and relative frequency of neurohormonal peptides-producing cells were demonstrated in the gut of the stomachless teleost, the Prussian carp, Carassius auratus Linnaeus, using 10 types of specific antisera raised against mammalian regulatory peptides. The gut of the Prussian carp was divided into five portions from proximal to distal (Segments I~V). Most of immunoreactive cells in the epithelial lining portion, between epithelial cells, were generally spherical or spindle shape having long cytoplasmic process that reached to the lumen (open typed cell) while cells showing round in shape (close typed cell) were found in the basal portions of epithelial lining occasionally. Somatostatin-, cholecystokinin (CCK)-8- and pancreatic polypeptide (PP)- immunoreactive cells were observed in this study. However, no serotonin-, glucagon-, chromogranin A-, secretin-, vasoactive intestinal peptide (VIP)-, substance P- and bombesin-immunoreactive cells were found. Somatostatin-immunoreactive cells were restricted to most proximal segments of the gut (Segment I) with rare frequency and CCK-8-immunoreactive cells were demonstrated in the proximal segments of the gut (Segments I and II) with a few to rare frequencies. In addition, pancreatic polypeptide-immunoreactive cells were demonstrated in the proximal to middle segments (Segments I~III) with moderated to rare frequencies. In conclusion, the distribution and relative frequency of these immunoreactive cells are well corresponded to the previous reports in stomachless teleost but somewhat peculiar patterns are also detected.

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Tibia Vara Caused by Focal Fibrocartilaginous Dysplasia(FFCD) - Case Report - (국소적 섬유연골성 이형성증(FFCD)에 의한 경골 내반 - 증례 보고 -)

  • Lee, Sang-Soo;Hwang, Ho-Yeun;Lee, Dong-Hee;Nam, Il-Hyun;Paik, Ae-Lan;Sohn, Kyung-Rak;Lee, Sang-Un
    • The Journal of the Korean bone and joint tumor society
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    • v.6 no.2
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    • pp.106-111
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    • 2000
  • Focal fibrocartilaginous dysplasia(FFCD) is an uncommon, benign condition associated with unilateral tibia vara among young children. FFCD has a typical plain radiographic finding, which has a concave radiolucent defect in the metadiaphyseal junction of medial aspect of the proximal tibia. The varus deformity occurs at the site of the lesion. Spontaneous remodeling and resolution of bony defect may be expected, but the corrective osteotomy may also be needed in some cases. The authors described a case of unilateral tibia vara caused by FFCD, diagnosed by excisional biopsy and treated with dome-shaped proximal tibial osteotomy and bone graft.

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New Technique for the Reconstruction of Both Anteromedial & Posterolateral Bundles of ACL (전방십자인대의 전내측 다발 및 후외측 다발을 각각 재건하는 새로운 수술 수기)

  • Ha Chul-Won;Awe Soo-Ik
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.195-199
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    • 2002
  • This article is to report a new technique for reconstruction of the anteromedial and posterolateral bundles of anterior cruciate ligament by separate tensioning and fixation of the each bundle. Method : Tibial and femoral tunnels were made with conventional technique of anterior cruciate ligament reconstruction. Tibial tunnel was enlarged $5\~7$ mm in anterior-posterior direction to make oval it in cross section. When preparing the Achilles tendon allograft, bone plug portion was trimmed as the conventional technique. The tendinous portion was trimmed as two separate bundles by dividing the tendinous portion longitudinally, so the graft is shaped like 'Y'. The bone plug portion of allograft was inserted into the femoral tunnel and fixed with absorbable cross pins. Two ligamentous portionss of the distal part of the grafts were tensioned separately at the external orifice. Anteromedial bundle was fastened under maximum tension with the knee flexed 90 degrees by post-tie method. The posterolateral bundle was fixed by the same technique with the knee in full extension. Then, an absorbable interference screw was inserted between the two bundles upto the upper end of the tibial tunnel, to get more initial rigidity of the reconstructed graft as well as to locate the two bundles in more anatomic position.

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Metastasising Recurrent Giant Cell Tumor - A Case Report - (폐 전이를 일으킨 재발성 거대세포종 - 증례 보고 -)

  • Kim, Tae-Seung;Park, Jun-Sic
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.2
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    • pp.73-79
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    • 2001
  • Giant cell tumor is usually found around the knee joint, especially in the distal femur or proximal tibia. Despite being classified as benign, it has unusual biological behavior of local aggressiveness and tend to have severely destructive lesion and develop rare pulmonary metastasis. Therefore, when the patient is presented to the physician with an expansile lytic lesion of challenging clinicopathologic entity extending to subchondral bone, the physician faces up to difficulties in treatment. We report a case of 25 years old patient having recurrent giant cell tumor in the right distal femur which developed metastasis to lung. The primary bone lesion was treated with local curettage and fillings with methylmethacrylate, but when he returned to the hospital two years later, the recurrence had developed with lung metastasis.

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ACL Reconstruction using Transtibial Femoral Tunnel at 10 or 2 O'clock Position - Technical Note - (10시 혹은 2시 방향의 경경골 대퇴 터널을 이용한 전방 십자 인대 재건술 - 수술 수기 -)

  • Cho, Sung-Do;Ko, Sang-Hun;Park, Mun-Soo;Jung, Kwang-Hwan;Cha, Jae-Ryong;Gwak, Chang-Youl;Kim, Sang-Woo
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.209-213
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    • 2006
  • Purpose: Conventional transtibial approach for the anterior cruciate ligament (ACL) reconstruction tended to place the femoral tunnel in too vertical position (11 or 1 o'clock), which could provide the postoperative anteroposterior (AP) stability but not provided the rotational stability. Therefore we present a surgical technique to make the transtibial femoral tunnel at 10 or 2 o'clock position. Surgical approach: To make a transtibial femoral tunnel at the 10 or 2 o'clock position, the direction and position of the tibial drill guide was important. We set the tibial drill guide at $40{\sim}45$ degrees and the intraarticular guide tip was 1 mm anterior and medial to the conventional site. The starting point for the guide pin on the proximal tibia was proximal to the pes anserinus and anterior to the medial collateral ligament. The tibial tunnel was initially drilled 1mm less than the diameter of the graft. Then femoral offset guide could be easily placed at 10 or 2 o'clock position through the tibial tunnel. The tibial tunnel and the femoral tunnel of 30 mm in length were made with the reamer that was same size with the graft. Conclusion: We report a surgical technique to create a transtibial femoral tunnel at 10 or 2 o'clock position in ACL reconstruction to provide the rotational stability as well as the AP stability.

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Evaluation of Medial Instability of the Knee with Ultrasonography - Technical note - (초음파를 이용한 슬관절 내측 불안정 평가 -측정기법-)

  • Kim, Jung-Man;Lee, Dong-Yeob;Koh, In-Jun;Kim, Seung-Min
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.1 no.2
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    • pp.73-77
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    • 2008
  • Purpose: The purpose of this study was to describe the method of dynamic sonographic measurements in the evaluation of the MCL injury of the knee joint while applying valgus and varus stress. Materials and Methods: Seven cases of MCL injury from January to April of 2008 was used for the study. For the evaluation of the medial instability, sonography was used immediately after injury, 6 weeks and 12 weeks after conservative treatment with limited motion brace. The length between the foot of the medial femoral epicondyle and the most proximal point of the tibial cortex was measured in 30 degrees flexion with valgus and varus stress of the knee joint. Results: The foot of the medial epicondyle and the starting point of the proximal tibial cortex underneath the round portion of the articular cartilage were always able to be seen on ultrasonography, even in varus and valgus stress with gravity in 30 degrees flexion of the knee joint. The results of measurements were always constant. Conclusion: Sonography can be used in evaluation of medial instability under the dynamic valgus and varus stress of the knee joint without further injury.

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Osteoid Osteoma of the Elbow in 2 years Old Child - A Case Report - (2세 소아에서 주관절에 발생한 유골골종 - 증례 보고 -)

  • Kim, Ki-Hyeong;Seo, Hyung-Yeon;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.2
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    • pp.198-202
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    • 2008
  • Although Osteoid osteoma has occurred in every bone of the body, it is rarely found at the elbow and in younger children than 5 years old. In 2 years old child, diagnosis can be delayed because of nonspecific clinical, radiological features and making it difficult for the child to communicate with physician. We report a case of osteoid osteoma of the distal humeral metaphysis with intracapsular nidus and synovitis of elbow in 2 years old girl who was treated by a surgical excision.

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Effect of Korean Medicine Treatments in Patients with Proximal Tibia Fracture: A Retrospective Observational Study (경골 근위부 골절 환자에 대한 한의학적 치료 효과: 후향적 관찰 연구)

  • Lee, Jung Min;Lee, Eun-Jung
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.3
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    • pp.141-149
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    • 2020
  • Objectives The purpose of this study is to find the effect of Korean medicine treatments on pain reduction and range of motion recovery in patients with proximal tibia fractures. Methods We studied 15 patients who had been diagnosed as proximal tibia fracture. This study was conducted as retrospective observational study which analyzed patient's medical records with IBM SPSS statistics 25 program. We used numeric rating scale to evaluate pain reduction and range of motion to observe the patient's recovery. Results The average of numeric rating scale reduced statistically significantly from 5.26±1.38 to 2.73±1.17 (p<0.001). The average of knee flexion range of motion increased statistically significantly from 81.11±34.34 to 117.66±19.01 (p<0.01). Conclusions We found that Korean medicine treatments have a positive effect on pain reduction and knee rom improvement in patients with proximal tibia fractures.

Analysis of Factors for Cartilage Regeneration in Patients Who Underwent High Tibial Osteotomy Combined with Microfracture (근위 경골 절골술과 미세 골절술을 함께 시행 받은 환자 군에서 연골 재생에 영향을 미치는 요인에 대한 분석)

  • Lee, Young Min;Song, Eun-Kyoo;Oh, Ho-Seok;Kim, Yu-Seok;Seon, Jong-Keun
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.404-412
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    • 2021
  • Purpose: This study examined the degree of cartilage regeneration by performing second-look arthroscopy in a group of patients who underwent high tibial osteotomy and microfractures for unicompartmental osteoarthritis of the medial knee joint and to determine the factors affecting cartilage regeneration. In addition, this study analyzed whether there is a relationship between the degree of cartilage regeneration and functional results. Materials and Methods: From 2007 to 2015, this study evaluated 81 cases who underwent second-look arthroscopy at the time of plate removal after a microfracture and high tibial osteotomy with a minimum two-year follow-up. The degree of femoral cartilage injury before surgery was classified by ICRS (International Cartilage Research Society), and all were grade III and IV. After second-look arthroscopy, cartilage regeneration was classified into a well-regenerated group (grade I, II) and a poorly regenerated group (grade III, IV). The independent factors influencing cartilage regeneration were identified through multivariate logistic regression analysis. In addition, the functional results were compared before and after surgery between the two groups using the Knee Society score (KSS) and the Western Ontario and McMaster Universities Osteoarthritis Index score (WOMAC). Results: Age, sex, body mass index, postoperative radiologic factors, and preoperative joint condition did not affect the degree of cartilage regeneration significantly. The large cartilage defect (≥2.0 cm2) (p=0.011) and the presence of kissing lesions (p=0.027) were associated with poor cartilage regeneration. No significant difference in the KSS and WOMAC scores was observed between the group with good and poor cartilage regeneration. Conclusion: The presence of a large cartilage defect and kissing lesions is associated with poor cartilage regeneration after high tibial osteotomy and microfracture. On the other hand, the degree of the regenerated cartilage did not show any correlation with the functional outcome.