• Title/Summary/Keyword: 변연 절제술

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Osteochondral Lesion of the Talus (거골의 골연골 병변)

  • Lee, K.B.
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.1
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    • pp.19-26
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    • 2007
  • 최근에 스포츠 손상이 증가하고 관절경을 이용한 치료가 발전하면서 조기에 더 적극적인 치료를 하는 추세이다. 또한 방사선 소견에 비하여 관절경하에서는 연골이 불안정하거나 분리되어 있는 경우도 있으므로 기존의 수술 적응증보다는 좀 더 광범위하게 관절경 검사 및 수술적 치료가 요구된다고 생각한다. 치료 방법을 하면 $1.5cm^2$ 이하의 병변을 가진 50세 이하의 환자는 관절경을 이용하여 변연 절제술, 연골하 천공, 연마, 미세 골절술, 소파술 등의 방법으로 치료할 수 있다. 같은 방법으로 50세 이상의 $3cm^2$ 이하의 병변을 가진 환자 중 mosaicplasty와 자가 연골 세포 이식술을 적용할 수 없는 환자에서 시도해볼 수 있다. $1.5\sim3cm^2$의 병변을 가진 50세 이하의 환자, 그전의 관절경적 치료로 실패한 경우에는 자가골 연골 이식 또는 자가 연골 세포 이식술을 이용하여 치료해야 한다. $3cm^2$ 이상의 병변을 가진 50세 이하의 환자는 자가 연골 세포 이식술이나 동종 골 연골 이식을 이용하여 치료하며, 50세 이상의 환자는 관절 고정술이나 족근 관절 인공치환술을 고려하는 것이 바람직하다.

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Arthroscopic Osteochondroplasty of Osteochondral Lesion of the Talus (거골 골연골 병변에 대한 관절경적 골연골성형술)

  • Lee, Myung Jin;Kim, Sung Soo;Wang, Lih;Lee, Chul Won;You, Sung Gon;Hwang, Jin Soo
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.2
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    • pp.134-139
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    • 2012
  • Purpose: To report the treatment results of arthroscopic osteochondroplasty in osteochondral lesion of the talus. Materials and Methods: This study included 32 patients who had osteochondral lesion of the talus treated with arthroscopic osteochondroplasty and were able to be followed up over 3 years from 1999 to 2007. The mean follow up period was 48 (38-108) months, and 22 male patients and 10 female patients with a mean age of 34 (20-56) years were included. Locations of lesion were evaluated with simple X-ray and magnetic resonance imaging (MRI), and severities of lesions were classified by Berndt and Harty classification. All cases were treated by arthroscopic debridement or microfracture. The treatment results were assessed by American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and subjective and functional score of Kailkkonen. The group treated by arthroscopic microfracture was compared with the group treated by arthroscopic debridement. Results: The mean AOFAS ankle-hindfoot scale was significantly improved 53 (${\pm}7$) points preoperatively to 84 (${\pm}8$) points postoperatively (P<0.001). The mean subjective and functional score was also improved 55 (${\pm}8$) points preoperatively to 88 (${\pm}8$) points postoperatively with statistical significant (P<0.001). There were no relations between the severity of lesions and the postoperative functional score of ankle (P>0.05). There were no significant differences in the clinical results between the group treated with arthroscopic microfracture and the group treated with arthroscopic debridement (P>0.05). Conclusion: Arthroscopic osteochondroplasty of osteochondral lesion of the talus shows excellent result in terms of patients' satisfaction. There were no significant differences in the clinical results between arthroscopic microfracture group and debridement group.

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Operative Treatment of the Tuberculous Arthritis on the Sternoclavicular Joint - A Report of Two Cases- (흉쇄 관절에 발생된 결핵성 관절염의 수술적 치료 - 2예 보고 -)

  • Park, Jin-Young;Kim, Jeong-Woo;Chun, Churl-Hong;Kwon, Seok-Hyun;Choi, Yun-Hong;Lee, Seok-Jung
    • Clinics in Shoulder and Elbow
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    • v.11 no.1
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    • pp.57-61
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    • 2008
  • Tuberculous arthritis on the sternoclavicular joint is an uncommon disease and a delayed diagnosis can be due to the obscure clinical symptoms. We should suspect tuberculous arthritis in patients with slowly progressive pain, swelling, mild fever and a previous history of tuberculosis. Early diagnosis is important through conducting a thorough physical examination and performing laboratory tests and radiologic study. Tuberculous arthritis on the sternoclavicular joint should be treated with a combination of systemic antituberculous agents and thorough surgical debridement in marked damaged joints. When performing this operation, it is important not only to minimized the injury of the costoclavicular ligament, but also to avoid injury to the surrounding the vital structures such as the mediastinum and pleura after aggressive resection or radical debridement. We describe here 2 cases of the tuberculous arthritis on the sternoclavicular joint: one case had a good result after surgical debridement with using an anti-tuberculous agent, and the other had fatal complications such as mediastinal abscess and pleural effusion after the operation.

Prosthetic rehabilitation by double-processing technique for edentulous patient with soft palate defect after maxillectomy: A case report (연구개를 포함한 상악골 절제술을 받은 완전 무치악 환자에서 이중 온성법으로 제작한 구개 폐색장치를 통한 보철수복: 증례 보고)

  • Park, Jin-Yong;Wang, Yuan-Kun;Song, Kwang-Yeob;Park, Ju-Mi;Lee, Jung-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.57 no.4
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    • pp.356-363
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    • 2019
  • A patient who went through maxillectomy can have soft palate defects including oronasal fistulas and suffer from dysphagia and dysarthria due to velopharyngeal insufficiency. This defect causes the food to enter nasal cavity and creates hypernasal sound which debilitates a quality of life. An obturator can rehabilitate the substantial oral tissue defects. The maxillary obturator separates the nasopharynx from the oropharynx during speech and deglutition by closing of the defect. For edentulous obturator patient, it is difficult to obtain proper retention due to reduced peripheral sealing. Therefore, the contours of the defects must be used to maximize the retention, stability, and support. Hollow type obturator can improve physiologic function by reducing weight than the traditional obturator. This case report describes a patient with hemi-maxillectomy who recovers mastication, speech, deglutition, and appearance with a maxillary obturator using physiological border molding of the velopharyngeal area and double-processing method.

Current Concepts of Osteochondral Lesions of Talus (거골 체 골연골 병변에 대한 최신 지견)

  • Park, Y.W.
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.1
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    • pp.27-32
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    • 2007
  • 골연골 병변에 관한 논문들을 살펴본 결과, 연구 방법, 각기 다른 치료 방법에 의해 얻어진 결과가 상당한 가변성을 보였다. 현 시점에서 골연골편 제거술 및 병변의 변연 절제와 천공술 그리고 자가 골연골 이식술 등이 가장 널리 이용되고 있으며 효과적인 치료 방법으로 사료된다. 그러나 가장 적절한 치료 수단이 무엇인지에 대한 명확한 결론을 유추하기 위해서는 무작위 임상 실험과 동일한 연구 방법에 의한 결과 측정의 비교가 우선되어져야 할 것으로 사료된다.

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Partial thickness tear: Debris vs. Repair (회전근 개 부전층 파열: 변연절제술가 봉합술)

  • Oh, Jeong-Hwan;Park, Jin-Young
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.1
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    • pp.34-39
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    • 2005
  • Partial thickness rotator cuff tears (PTRCTs) are now a well-established clinical entity, yrt there is no consensus in regards to surgical management. Recommended treatment varies widely from simple debridement of the torn tendon to subacromial decompression to excision of the degenerative tendon and repair. Surgery may be performed using an open, arthroscopically assisted (miniopen), or entirely arthroscopic procedure. The advantages and disadvantages of open and arthroscopic procedures may lie in the balance between precision and morbidity. Visualization of both the articular and bursal surfaces is mandatory to determine the level of rotator cuff disease and formulate a treatment strategy. Because these tear often are secondary finding, recognition of the primary pathology is critical. Treatment of the primary problem usually remedies the partial tear. However, when there is significant PTRCT, an arthroscopic or open repair of the diseased tendon will give the most consistent results.

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Descending Necrotizing Mediastinitis Caused by Yeast -A case report- (이스트에 의한 하행 괴사성 종격동염 -치험 1예-)

  • 윤영철;김성룡;전희재;최강주;이양행;황윤호;조광현
    • Journal of Chest Surgery
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    • v.37 no.4
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    • pp.386-389
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    • 2004
  • Descending nectorizing mediastinitis (DNM). represents a virulent form of mediastinal infection requiring prompt diagnosis and treatment to reduce the high morbidity mortality associated with this disease. Intr. avenous broad-spectrum antibiotic therapy alone is not efficient without adequate surgical drainage of the cervical and mediastinal collections, extensive debridement and excision of necrotic tissue, and wide mediastino-pleural irrigation. A 38-year-old man admitted via emergency room with painful left neck swelling and uncontrolled high fever. Chest computed tomogram showed left paratracheal abscess descending into the superior and anterior mediastinum. Transcervical mediastinal drainage was performed with 26 Fr. chest tube and left paratracheal drainage was performed with Penrose drain in urgency. Culture and sensitivity test grew Yeast. The drains removed via gradually shortening on day 39 after surgery.

Generalized Tetanus from a Foot Injury (족부 부상으로 인한 전신 파상풍)

  • Park, Hong-Gi;Kim, Han Soul
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.5
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    • pp.433-439
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    • 2021
  • The definitive and effective method for tetanus prevention has contributed to decreased incidence and mortality of tetanus infections in developed countries. On the other hand, there has been a recent increase in incidence due to the lack of awareness of the disease and lack of adherence to preventive measures. Tetanus infections can be fatal. Therefore, prevention must be the utmost priority, followed by aggressive surgical management along with supportive care. The authors present a case of a 59-year-old male patient diagnosed with a generalized tetanus infection from a foot injury. The patient recovered successfully after aggressive surgical debridement and amputation of the infected toe at the metatarsal level, followed by two months of supportive care.

Treatment of Freiberg Disease with Metatarsophalangeal Arthroscopy - A Case Report- (중족지 관절경을 이용한 Freiberg 병의 치료 -1예 보고-)

  • Ahn, Jae-Hoon;Lee, Seung-Hun;Lee, Kwang-Won;Choy, Won-Sik;Kam, Byoung-Sup
    • Journal of the Korean Arthroscopy Society
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    • v.11 no.1
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    • pp.59-62
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    • 2007
  • Freiberg disease is a relatively rare osteochondrosis of metatarsal head, which usually involves the 2nd metatarsal of adolescent females. Various open surgical treatments have been recommended; arthrotomy and removal of loose body, dorsiflexion osteotomy and resection of the metatarsal head. Arthroscopic treatment for Freiberg disease has a merit of shortening the recovery period and reducing the postoperative stiffness. We report a case of early stage Freiberg disease treated with metatarsophalangeal arthroscopic excision of loose body and debridement of the 2nd metatarsophalangeal joint.

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Treatment Outcomes of Sacral Giant Cell Tumor (천골 거대 세포종의 치료 결과)

  • Kong, Chang-Bae;Lee, Kwang-Youl;Song, Won-Seok;Cho, Wan Hyeong;Koh, Jae-Soo;Jeon, Dae-Geun;Lee, Soo-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.19 no.2
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    • pp.43-49
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    • 2013
  • Purpose: We analyzed the treatment outcomes of patients with sacral giant cell tumor. Materials and Methods: We retrospectively reviewed 7 patients with giant cell tumor of the sacrum who were treated at out institution between 1990 and 2012. Results: There were 2 men and 5 women with mean age of 23.6 years. The average follow up was 52.3 months (range, 15-73 months). Six patients received surgical treatment. Intralesional curettage was performed for the 5 patients and marginal resection for another one patient. The remaining one patient was received radiation only. The patients who received radiation therapy and marginal excision had no residual or recurrent tumors. Of 5 patients with intra-lesional excision, one patient needs one more operation; two patients need two more operation for local control of the giant cell tumor. The remaining two patients failed to gain local control in spite of additional treatments. Conclusion: For the treatment of sacral giant cell tumor, intralesional resection can be one of the treatments option with minimal neurologic injury. Furthermore, radiation therapy can be recommended when complete excision or curettage is impractical.