• Title/Summary/Keyword: 관절고정술

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Percutaneous Fixation with Cannulated Screws and Ilizarov External Fixator in Triplane Fracture of the Distal Tibial Epiphysis in Children (소아 경골 원위 골단부 삼면 골절의 경피적 나사못 고정술과 Ilizarov 외고정 장치를 이용한 치료)

  • Hyun, Yun-Seok;Kim, Gab-Lae;Lee, Kwang-Nam;Lee, Eun-Su
    • Journal of Korean Foot and Ankle Society
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    • v.12 no.2
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    • pp.180-184
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    • 2008
  • Purpose: To evaluate the result of percutaneous fixation with cannulated screws and Ilizarov external fixator in triplane fracture of the distal tibial epiphysis in children. Materials and Methods: Between May 2004 and December 2007, 14 cases with triplane fractures were treated by percutaneous fixation with cannulated screws and Ilizarov external fixator after underwent CT imaging to assess the fracture pattern, articular disruption and to plan further management. Mean age and follow-up period were 14.1 years old and 15 months respectively. Results: There were satisfactory results in all 14 cases that had excellent reduction and stable fixation. All cases regained full range of movement within 6 weeks. Conclusion: We obtained satisfactory result after percutaneous fixation with cannulated screws and Ilizarov external fixator in triplane fractures of the distal tibial epiphysis in children.

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The Comparison of Bonded/Unbonded Stem-Cement Interface in Total Hip Replacement -Experimental Study (인공 고관절 전치환술에서 주대-시멘트 경계층의 접착 및 비접착 고정술의 비교를 위한 실험적 연구)

  • Han, J.H.;Yoon, Y.S.;Lee, J.J.
    • Proceedings of the KSME Conference
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    • 2001.06a
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    • pp.951-955
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    • 2001
  • The experimental comparison between bonded and unbonded types stem-cement interface was carried out on axisymmetric stem-cement-aluminum model of the femoral component of a total hip replacement. Human femur was modeled in non-tapered and tapered($7.5^{\circ}$) aluminum hollow cylinders to emulate the diaphyseal and metaphyseal segments of the femur. For unbonded type, we tested stems with three different taper angles($5^{\circ},\;7.5^{\circ},\;10^{\circ}$). In every case, the cement-aluminum interface was designed to endure 8MPa shear strength. (a measured value at cement-bone interface) We tested aluminum models under axial loading for both cases. As an experimental result, it was found that unbonded stem sustained more axial load as bonded stem in both cases, diaphyseal and metaphyseal models. The unbonded types failed in cement mantle under axial compressive load, while the bonded ones failed in shear at cement-aluminum interface. These results suggest that a polished stem will sustain much higher axial load than a roughened stem. And a polished stem will make more stable cement-bone interface that may promote better osteosythesis around the stem.

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Closed Reduction and Fixation of Metatarsal Head and Neck Fractures Using Antegrade Intramedullary K-wire (6 Cases Report) (전향성 골수내 K-강선을 이용한 중족골 두 및 경부 골절의 비관혈적 정복 및 고정술(6예 보고))

  • Kim, Hyong-Nyun;Lim, Hee-Joon;Park, Yong-Wook
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.1
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    • pp.91-94
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    • 2009
  • Metatarsal head and neck fractures are injuries that often result from a direct blow of a heavy objects to the metatarsal head. The head is often impacted or displaced to the plantar aspect that if not treated may cause malunion which later induces painful plantar calluses. If the fracture fragment is large enough, closed reduction may be successfully performed, but when the fragment is small or closed reduction is unsuccessful, open reduction is needed. We present our reduction and fixation technique for the metatarsal head and neck fractures using antegrade intramedullary Kirschner wire (K-wire) without opening the fracture site or infringing the metatarsophalangeal (MTP) joint which allows immediate motion of the joint and partial weight bearing in a stiff soled shoe.

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Using the Arthroscopic Remplissage of Anterior Shoulder Instability with Hill-Sachs Lesion (전방 견관절 불안정성에서 Hill-sachs 병변의 관절경적 Remplissage)

  • Ko, Sang-Hun;Jung, Kwang-Hwan;Shin, Seung-Myeong;Park, Han-Chang
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.53-58
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    • 2011
  • Purpose: We evaluated the minimal 1 year follow-up results (shoulder stability and the clinical and functional results) for the Remplissage technique to fill a Hill-Sachs lesion. Materials and Methods: The subjects were 12 patients who could be followed up for more than 12 months after the "Remplissage" procedures in our hospital from December 2008 to November 2009. Their mean age was 27.9 years old and the mean follow-up was 19 months. The evaluations included the ROM, the ASES score, the KSSI score, the ROWE score and postoperative MRI. Results: On the postoperative functional evaluation after an average of 16 months, the ASES score improved from 50.8 preoperatively to 78.3 postoperatively, the KSSI score improved form 44.5 preoperatively to 81.0 postoperatively and the ROWE score improved from 40.2 preoperatively to 84.3 postoperatively. After an average 14 months for all the cases, the range of movement was nearly in the normal range, which is 178.6${\pm}$18.6 (165~180) degrees for forward flexion and 49.3${\pm}$10 (43~60) degrees for external rotation. Conclusion: For recurrent shoulder instability with a large Hill-Sachs lesion, the Remplissage technique has a good outcome after more than 1 year follow-up in terms of the shoulder stability and the clinical and functional results.

The Surgical Treatment of Type V Acute Acromioclavicular Joint Dislocation Using Suture Anchor and Kirschner Wire (봉합 나사못과 Kirschner 강선을 이용한 제 5형 급성 견봉 쇄골 관절 탈구의 수술적 치료)

  • Jung, Gu-Hee;Cho, Chyul-Hyun;Jang, Su-Jin;Jang, Jae-Ho;Kim, Jae-Do
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.217-222
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    • 2010
  • Purpose: We wanted to evaluate the clinical outcomes after operative treatment using two suture anchors and Kirschner wire for treating acute Rockwood type V acromioclavicular joint dislocation Materials and Methods: Between May 2006 and May 2009, 10 patients underwent surgical treatment for acute Rockwood type V acromioclavicular joint dislocation using two suture anchors and Kirschner wire and they were followed for a mean of 12.0 (range: 7-31) months. We analyzed the functional results by the Korean shoulder score, the Constant-Murley score and the reduction state of the acromioclavicular joint at the last follow-up. Results: All the cases achieved a satisfactory outcome. The mean Korean shoulder score was 89.9 (range: 81-100) points and the mean Constant-Murley score was 87.8 (range: 82-93) points. According to the radiologic findings, 8 patients achieved anatomical reduction of the acromioclavicular joint: there was a slight loss of reduction in one patient and a partial loss of reduction in one patient. None of the patients had deep infection or re-dislocation. Conclusion: The operative treatment using two suture anchors and Kirschner wire may be used for acute Rockwood type V acromioclavicular joint dislocation, and it has an advantage in that it can prevent chondral injury of the joint.

Intra-articular Corticosteroid Treatment of Biceps Tenosynovitis in a Dog (개에서 두갈래근 힘줄 윤활막염의 관절강 내 코티코스테로이드 치료 1예)

  • Lee, Jae-Yeon;Jee, Hyun-Chul;Lee, Ki-Ja;Park, Seong-Jun;Choi, Ho-Jung;Lee, Young-Won;Kim, Myung-Cheol;Jeong, Seong-Mok
    • Journal of Veterinary Clinics
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    • v.24 no.1
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    • pp.32-34
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    • 2007
  • A 3-year-old, 35kg, neutered male Borzoi was admitted with a history of intermittent weight-bearing left forelimb lameness. Physical examination revealed pain response on left bicipital tendon during palpation of the tendon and shoulder flexion and extension. Radiographic findings of the left shoulder joint included intertubercular grove osteophytes and periarticular changes. Arthrograms revealed a roughened and irregular appearance to the biceps tendon. Synovial fluid analysis is consistent with degenerated joint disease. It was diagnosed as biceps tenosynovitis on the basis of history, physical examination, radiography and arthrograms. The dog was treated with medical management. Medical treatment included an aseptic intra-articular injection of 40mg methylprednisolone acetate in the left shoulder and strict exercise restriction. Three weeks later, the dog responded well to glucocorticoid therapy.

Arthroscopic Treatment of Osteochondral Fractures Associated with Patella Dislocation (슬개골 탈구에 동반된 골연골 골절의 관절경적 치료)

  • Lee Byung-Ill;Min Kyung-Dae;Choi Hyung-Suk
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.104-110
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    • 2001
  • Purpose : To analyze the patterns of osteochondral fracture associated with patellar dislocation and to assess the results of arthroscopic treatment. Materials and Methods : Fourteen patients were treated from March, 1989 to April, 1998 for patellar dislocations with osteochondral fracture. The average follow-up was 32 months. All were treated by arthroscopic procedures. The location and size of the fracture fragments were recorded. To assess the functional results, we used Larsen & Lauridson's score system. Results : Osteochondral fractures were found 8 cases in medial side of patella, 1 case in lateral side of patella, 5 cases in lateral margin of lateral femoral condyle. The range of maximal diameter of osteochondral fragment was from 1cm to 4.2cm. Treatments include fragment excision only in 6 cases, excision and medial retinacular repair in 2 cases, excision and medial retinacular repair and lateral retinacular release in 3 cases, and internal fixation only in 3 cases. The functional results were excellent in 5 cases$(36\%)$. good in 6 cases$(43\%)$, fair in 1 case$(7\%)$ and poor in 2 cases$(14\%)$. Conclusion : In osteochondral fractures associated with patellar dislocation, arthroscopic treatment is useful to diagnose precisely, to determine proper treatment modality, and to minimize the complications.

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Arthscopic Treatment of Osteochondritis Dissecans in Femoral Condyle (관절경을 이용한 대퇴골과 박리성 골연골염에 대한 치료)

  • Kim Sung-Jung;Kyung Hee-Soo;Ihn Joo-Chul;Lee Seong-Man
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.138-143
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    • 2000
  • Purpose : We analyzed clinical and radiological results of the treatment of osteochondritis dissecans in the femoral condyle under arthroscopic guidance. Materials and Methods : The study group consists 19 cases in 17 patients. Average follow up period was 34 months and average age was 16 years. The cases were classified by 4 different groups, using the fellowing system: Group 1-stable lesion and no specific treatment after arthroscopic examination; Group 2-early separation and multiple drilling; Croup 3-unstable lesion and Herbert screw fixation; Croup 4-loose body removal and/or crater curettage. The results were analyzed by the criteria of Hughston which including clinical and radiologic outcomes. Results : There were 14 cases$(74\%)$ of good and excellent results in 19 knees in which, $75\%$(3/4) in Group 1, $75\%$(3/4) in Group 2, $86\%$(7/8) in Group 3 and $33\%$(1/3) in Group 4. The result of Herbert screw fixation group was better than that of other groups with statistically significant differences. Conclusion : In the treatment of osteochondritis dissecans of skekletally immature patients, arthroscopic finding was reliable guidance in decision of treatment method and active fixation was recommended in patients with large, unstable lesion.

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Alternative Fixation Technique for Bony Bankart Lesion with Using Suture Anchor (봉합나사와 골터널을 이용한 골성 반카르트 병변의 고정)

  • Kim, Byung-Kook;Lee, Ho-Jae;Kim, Go-Tak;Dan, Jinmyoung
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.6
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    • pp.574-578
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    • 2019
  • For the treatment of a bony Bankart lesion accompanied by an acute traumatic shoulder dislocation, anatomical reduction and stable fixation of the bone fragment and glenohumeral ligament are essential to avoid chronic instability or degenerative changes. If the Bankart lesion has large bony pieces or comminuted fragments, it can be difficult to perform precise and secure fixation of the big intraarticular fragment to the fracture site because of the limited visualization of the arthroscopic procedure. In addition, in the case of the open procedure, it requires an extensive surgical dissection to access the fractured fragment, which may cause surgical approach-related morbidity, such as neurovascular complications, delayed subscapularis healing, and increased risk of stiffness. This paper describes an alternative open suture anchor technique for a large bony Bankart lesion, which was secured anatomically with squared knots after a shuttle relay through bony tunnels and adjacent soft tissue and labrum. This technique can achieve anatomical and firm fixation under direct vision, and reduce the number of surgery related morbidities.

A Case of Tarsocrural Arthrodesis in a Dog with Hock Dropped (개에서 뒷발목하퇴관절 고정술의 일례)

  • 연성찬;구자민;황재민;김현희;이원익
    • Journal of Veterinary Clinics
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    • v.18 no.2
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    • pp.164-166
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    • 2001
  • An eight-month old female mixed breed dog was presented to the at Gyeongsang National University Animal Hospital, for tarsocrural arthrodesis. Previously the dog had been presented to a local animal clinic. Orthopedic and blood examinations were conducted. There was absent response of conscious proprioception on the right tarsocrural articulation. The dog stood knuckled onto the digits and had hock dropped but showed normal values in WBC, RBC, Hb, PCV, BUN, creatine, glucose, cholesterol, AST and ALT analyses. The dog was anesthetized and prepared for aseptic surgery. Steinmann pin and Joshi external fixators were applied(bilaterally). 11 weeks after the operation, the external fixators were removed from the bones. The hock dropped was well stabilized, but mild knuckling of distal metatarsopharangeal joint was remained.

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