• Title/Summary/Keyword: 근골격계수술

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Ultrasound-Guided Regional Nerve Block in Lower Extremity (하지에서의 초음파 유도 국소 신경 차단술)

  • Kang, Chan
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.5 no.1
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    • pp.50-59
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    • 2012
  • In the domain of orthopaedic surgery, application of regional nerve block for surgery or pain control in upper and lower extremities has been increased. By performing regional block of popliteal (sciatic), femoral, proximal saphenous nerve and ankle block under guidance of ultrasound, not only the safety, but also success rate of the procedure has increased, and amount of local anesthetics could be used less, too. Since the perineural single injection or continuous catheterization of diluted local anesthetics was performed more precisely and easily by the guidance of ultrasound, postoperative pain could be controlled without complications of PCA such as nausea, vomiting, etc. We will discuss about this ultrasound guided regional nerve block.

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Development and evaluation of a mobile app-based musculoskeletal exercise program for operating room nurses (수술실 간호사를 위한 앱 기반 근골격계 운동프로그램의 개발 및 효과검증)

  • Hwawon Nam;Sangeun Jun
    • Journal of Korean Biological Nursing Science
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    • v.25 no.3
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    • pp.215-227
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    • 2023
  • Purpose: The aim of this study was to develop a mobile app-based musculoskeletal exercise program (AMSEP) for operating room (OR) nurses and evaluate its effects on self-efficacy, the flexibility of the shoulders, lower back, and legs, and musculoskeletal symptoms and fatigue. Methods: The AMSEP was developed based on the information-motivation-behavioral skill model. In total, 48 OR nurses were recruited at a university hospital in Korea and divided into an experimental group (n=24) and a control group (n=24), matched for career experience in the OR. The experimental group participated in the AMSEP, while the control group received a booklet regarding musculoskeletal exercise. Results: The experimental group showed significant increases in self-efficacy (t = -2.77, p = .008) and flexibility of the right shoulder (t = -4.08, p < .001), left shoulder (t = -3.28, p = .002), lower back (t = -3.75, p < .001), and legs (t = -3.96, p < .001) compared to the control group. Musculoskeletal symptoms (t = 2.75, p = .008), and fatigue (Z = -1.98, p = .048) significantly decreased in the experimental group compared to the control group. Conclusion: Our findings indicate that the AMSEP for OR nurses provided information on the prevention of musculoskeletal disorders and methods of exercise, as well as an opportunity for continued exercise performance through self-management. The AMSEP was easily accessible and effective in increasing self-efficacy and flexibility and reducing musculoskeletal symptoms and fatigue.

Study of Appropriate Increment during VRT Rendering before Musculoskeletal Surgery (근골격계 수술전 VRT Rendering시 적절한 increment에 대한 연구)

  • Gang, Heon-Hyo;Kim, Dong-Hyun
    • Journal of the Korean Society of Radiology
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    • v.13 no.5
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    • pp.675-681
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    • 2019
  • The purpose of this study was to investigate the effect of increasing the amount of 3D volume imaging on the hand, knee, and foot human phantom in CT, After analyzing the data, three - dimensional volumetric images were implemented using MMWP program to evaluate reproducibility. First, the data amount of three human phantoms according to each increment was analyzed. Secondly, the reproducibility evaluation and the measured length were compared. As a result of analyzing the amount of image data for each phantom according to the increment, it was confirmed that the amount of data is reduced to about 1/10 when the increment is set to 1.0 mm as compared with the case where the increment is set to 0.1 mm. In the evaluation of the feasibility, gap was generated from 0.7mm for hand phantom, 0.6mm for knee phantom and foot phantom, and it was confirmed that even when the actual phantom and actual length were compared, the length was much different and the implementation was lowered. As the increment is closer to 1.0mm, the number of images is small and the 3D implementation time is small. Therefore, it is best to determine the increase before the gap of the image is generated and to apply the Increment for preoperative diagnosis. We hope that this study will be an indicator of the accurate increment setting when implementing 3D image through VRT Rendering after CT scan.

Osteoid Osteoma in Wrist: A Case Report (수근부에 발생한 유골 골종: 증례 보고)

  • Lee, Chae-Chil;Kim, Sang Woo;Jung, Seung-Hyun
    • The Journal of the Korean bone and joint tumor society
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    • v.20 no.2
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    • pp.94-98
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    • 2014
  • Osteoid osteoma can occur in all parts of the skeletal system. More than half occur in lower extremity and rare in wrist. Clinically pain is almost the only symptom worse at night and which is characterized by a rapid improvement by NSAID. We report the cases of osteoid osteoma which shows the characteristic symptoms and got a good results with appropriate imaging work up and surgical treatment.

Rehabilitation of the Throwing Athlete (던지기 선수에서의 재활)

  • Youn, Te-Hyun;Moon, Young-Lae
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.2
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    • pp.77-82
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    • 2007
  • The thrower's shoulders require a delicate balance between mobility and functional stability. First step to successful nonoperative management is an accurate diagnostic approach. Rehabilitation program follows a well-organized, multiphase approach with focus on controlling painful inflammation, restoring muscle balance, obtaining joint flexibility, improving proprioception and neuromuscular control, and effectively returning to competitive pitching. In this article, the typical musculoskeletal profile of the overhead thrower and various rehabilitation programs for specific injuries are discussed.

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Ultrasound-Guided Femorosciatic Nerve Block (초음파 유도 대퇴좌골 신경 차단술)

  • Kang, Chan;Kim, Young-Mo;Hwang, Deuk-Soo;Kim, Joung-Hun;Park, Jun-Young;Lee, Woo-Yong
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.3 no.2
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    • pp.74-78
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    • 2010
  • Since the extent of use of musculoskeletal ultrasound in orthopaedic surgery is expanding, popliteal block(sciatic nerve block) and femoral nerve block(saphenous nerve block) are easily and safely performed without complications such as nerve injury or incomplete block. Also, due to the expanding use of ultrasound, orthopaedic surgery of not only foot but also ankle and lower leg could be done without general anesthesia or spinal anesthesia. We describe a detailed technique for ultrasound-guided femorosciatic nerve block based on the experience over 120 cases.

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Mesenchymal Chondrosarcoma of the Calcaneous (종골에 발생한 간엽성 연골육종 - 1예 보고 -)

  • Sung, Ki-Sun;Son, Jeong-Gyeong;Cho, Eun-Yoon
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.219-223
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    • 2005
  • Mesenchymal chondrosarcoma is very rare and mostly occurs in lower extremity, especially femur, head and face, and pelvis in order. An eleven-year old male patient suffered from left heel pain for several months and underwent biopsy at another hospital. A Malignant bone tumor was suspected, so the patient was transferred to our hospital. We reviewed the outside pathologic slide, which revealed the diagnosis of mesenchymal chondrosarcoma. It was treated by a below knee amputation. Three months later, a chest computed tomography (CT) revealed multiple metastatic nodules in both lungs. All metastatic nodules were surgically excised and the patient received postoperative chemotherapy. As far as our knowledge, mesenchymal chondrosarcoma in the calcaneus is the first case in the world. Thus, we report a case of mesenchymal chondrosarcoma in the calcaneus with thorough review of documents.

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Three Dimensional Printing Technique and Its Application to Bone Tumor Surgery (3차원 프린팅 기술과 이를 활용한 골종양 수술)

  • Kang, Hyun Guy;Park, Jong Woong;Park, Dae Woo
    • Journal of the Korean Orthopaedic Association
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    • v.53 no.6
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    • pp.466-477
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    • 2018
  • Orthopaedics is an area where 3-dimensional (3D) printing technology is most likely to be utilized because it has been used to treat a range of diseases of the whole body. For arthritis, spinal diseases, trauma, deformities, and tumors, 3D printing can be used in the form of anatomical models, surgical guides, metal implants, bio-ceramic body reconstruction, and orthosis. In particular, in orthopaedic oncology, patients have a wide variety of tumor locations, but limited options for the limb salvage surgery have resulted in many complications. Currently, 3D printing personalized implants can be fabricated easily in a short time, and it is anticipated that all bone tumors in various surgical sites will be reconstructed properly. An improvement of 3D printing technology in the healthcare field requires close cooperation with many professionals in the design, printing, and validation processes. The government, which has determined that it can promote the development of 3D printing-related industries in other fields by leading the use of 3D printing in the medical field, is also actively supporting with an emphasis on promotion rather than regulation. In this review, the experience of using 3D printing technology for bone tumor surgery was shared, expecting orthopaedic surgeons to lead 3D printing in the medical field.

Metastatic Pathologic Fractures in Lower Extremities Treated with the Locking Plate (잠김 금속판을 이용한 하지의 전이성 병적 골절에 대한 치료)

  • Seo, Chang-Young;Jung, Sung-Taek
    • The Journal of the Korean bone and joint tumor society
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    • v.16 no.2
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    • pp.80-86
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    • 2010
  • Purpose: The skeleton is commonly affected by metastatic cancer. The purpose of this study was to evaluate the results of treating metastatic pathologic fractures in lower extremities using locking plates. Materials and Methods: Between 2004 and 2010, we evaluated 12 patients (13 cases) of metastatic pathologic fractures in lower extremities, treated with the locking plate. Mean patient age was 62.2 years (range, 50-81 years), the locations of the fractures were; proximal femur in 2 cases, femoral mid-shaft in 3, distal femur in 3, proximal tibia in 4, and distal tibia in 1 case. The interval to wheelchair ambulation, pain relief and complications were evaluated. Additionally, we assessed operation time and postoperative blood loss. Results: Mean time from operation to wheelchair ambulation was 3.2 days (range, 1-6 days). Mean VAS scores improved from a preoperative score of 8.1 points (range, 7-9 points) to a score of 2.7 points (range, 2-4 points) at 1 week postoperatively. No early complications associated with surgery were encountered. Mean operation time was 88.4 minutes (range, 70-105 minutes), and mean postoperative blood loss was 246.5 ml (range, 130-320 ml). Conclusion: Internal fixation of metastatic pathologic fractures using a locking plate in the lower extremity can be an effective treatment option in the meta- or diaphyseal area of long bones with massive bony destruction or poor bone stock by offering early ambulation, pain relief and low postoperative complications.

Analysis of Frequent Disease and Medical Expenses Structure of Patients Admitted in a Vaterans Hospital (일개 보훈병원 입원환자의 상병 및 진료비 구조분석)

  • Kim, Kyoung-Hwan;Lee, Sok-Goo;Kim, Jeong-Yeon
    • Journal of agricultural medicine and community health
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    • v.30 no.1
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    • pp.1-14
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    • 2005
  • Objectives: This study attempts to analyze the length of hospital stay and expenses of frequent disease admitted in a Vaterans Hospital. Methods: Data was collected from January 1, 2001 to December 31, 2003 from the Claim records of 9,640 patients in a Vaterans Hospital. Results: The results were as follows: 1. In age & sex distribution, there was male 70.9%, female 29.1%, and 35.8% of them is 70 age group. Frequency by insurance program was Health insurance 78.1%, Medical aid 14.2%, no insurance 4.1%, others 3.6%. Distribution of each department was internal medicine 28.3%, orthopedic surgery 21.3%, surgery 16.6%, neurosurgey 7.1%, pediatrics 5.9%. Also, in the veterans group, male to female patient ratio was 99.3% male to 0.7% female, them over 70 years old was 51.6%, and them which live in daejeon was 43.5%. 2. In frequency of disease, there was gastroenteritis 4.8%, pneumonia 3.8%, cartaract 3.7%, cerebral infarct 3.2%, hyperplasia of prostate 3.0%. In frequency of korean standard classification of diseases, there was injury and poisoning and certain other consequences of external causes 17.1%, diseases of digestive system 16.1%, diseases of musculoskeletal system and connective tissue 13.9%, diseases of respiratory system 9.4%, diseases of genitourinary system 8.6%. Also, in veterans group, frequency of them was diseases of musculoskeletal system and connective tissue 19.4%, diseases of digestive system 16.8%, injury and poisoning and certain other consequences of external causes 15.7%, diseases of genitourinary system 9.7%, diseases of circuatory system 8.2%. 3. Average length of hospital stay was 29.0 days for total patients, 51.8 days for the veterans group, 15.7 days for the non-veterans one. Average total expenses was 3,669,579 won, the veterans group 7,263,877 won, the non-veterans one 1,560,333 won. The ratio of insurer to insuree was 55.2 : 44.8, the ratio of amount paid by patient in the veterans group 61.7%, in the non-veterans one 33.0%. 4. In items of medical expenses, fee for hospital accommodation was 34.7%, fee for medication 13.2%(injection 7.8%, drug 5.4%), fee for service 48.6%(physical therapy 26.3%, operation 9.7%, laboratory examination 5.2%, radiological examination 3.1%, etc), others 3.4%. In them for the veterans group, fee for physical therapy was 35.3%, fee for hospital accommodation 35.2%, fee for injection 6.2%, fee for operation 5.9%, for the non-veterans one, fee for hospital accommodation 35.7%, fee for operation 16.4%, fee for injection 11.4%, fee for laboratory examination 8.3%. 5. In the comparison of the frequency by Korean standard classification of diseases and distance between the hospital and home, the region under 21.5Km was more frequent in symptoms, signs an abnormal clinical and laboratory findings 56.0%, injury and poisoning and certain other consequences of external causes 55.6%, diseases of the eye and adnexa 52.9%, the one over 21.5Km was more frequent in neoplasms 57.4%, diseases of musculoskeletal system and connective tissue 55.9%, diseases of genitourinary system 53.5%.

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