• Title/Summary/Keyword: 정형외과

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Early Result of Coronary Artery Bypass Surgery (관상동맥 우회술의 조기성적)

  • Park, Jae-Hyeong;Lee, Won-Yong;Kim, Eung-Jung;Hong, Gi-U
    • Journal of Chest Surgery
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    • v.30 no.2
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    • pp.158-163
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    • 1997
  • From July 1994 to August 1995, 32 patients underwent coronary artery bypass surgery. There were 14 men and 18 women. The mean age was 59 years (range from 37 to 81 years). Preoperatively 26 patients had unstable angina pectoris and 6 patients had stable angina pectoris. Nine patients had previous myocardial infarction hi tory. Five patients had preoperative left ventricular ejection fraction of 40% or less, The involved risk factors were as follows ; smoking 19 cases, hypertension 16 cases, hypercholesterolemia 14 cases, diabetes mellitus 6 cases, and obesity 3 cases.21 patients had three-vessel disease, 7 patients had two-vessel disease, 2 patients had one-vessel disease and 2 patients had left main coronary artery disease. We performed 103 distal bypasses out of 32 cases, and the mean number of grafts per patients is 3.22. We used arterial grafts (left internal mammary artery,)1, radial artery; 2) in 32% of total grafts. Postoperative complications were low cardiac output, perioperative myocardial infarction, respiratory failure and atrial fibrillation, etc. Early mortality was 6.25% (2/32). The causes of deaths were low cardiac output (1), and perioperative myocardial infarction(1).

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Treatment of Benign Bone Tumor with Xenograft (이종골 이식을 이용한 양성 골 종양 치료)

  • Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.1 no.2
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    • pp.189-193
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    • 1995
  • The authors reviewed 49 cases(48 patients) of benign bone tumor who had surgical treatment with xenograft at department of orthopedic surgery, Seoul National University Hospital from May, 1980 to May, 1994. Materials consist of 21 males and 27 females. The mean age at operation was 20.1 years(range : 4 -55 years) and the mean follow up period was 25.4 months(range : 7 - 85 months). We did xenograft only in 34 cases and xenograft mixed with autograft in 15 cases(14 cases, from ilium, 1 case from femur). The used materials for xenograft were $Lubboc^{(R)}$ in 29 cases, $Surgibone^{(R)}$ in 17 cases and $Pyrost^{(R)}$ in 3 cases. The average durations when bony union was achieved in radiograph were 13.8 weeks in whole cases, 12.5 weeks(range : 8 - 24 weeks) in $Lubboc^{(R)}$ graft cases and 15.7 weeks(range : 6 - 24 weeks) in $Surgibone^{(R)}$ graft cases. The tumor recurred in 4 cases, 1 case was recurred giant cell tumor at distal femur treated with mixed auto and $Lubboc^{(R)}$ graft and 2 cases were large cystic lesions at the proximal humerus diagnosed as simple bone cyst and at distal tibia diagnosed as fibrous dysplasia treated with $Surgibone^{(R)}$ graft and 1 case was aneurysmal bone cyst of the proximal tibia treated with $Lubboc^{(R)}$ graft. Wound infection occurred in 1 case. More transfusion was done in the cases that the lesion was larger than 5cm, the lesions were in the ilium or femur and the cases that were treated with mixed with autograft. This study implies that benign bone tumor is successfully treqated with curettage and xenograft or xenograft mixed with autograft. And also this method will reduce morbidity of donor site, intraoperative bleeding and post-transfusion complications.

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Treatment of the Tibia Shaft Fractures with Ender Nails (Ender Nail을 이용한 경골간부 골절의 치료)

  • Kim, In-Ki;Lee, Dong-Chul;Seo, Jae-Sung;Ahn, Myun-Whan;Kim, Se-Dong;Ahn, Jong-Chul
    • Journal of Yeungnam Medical Science
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    • v.9 no.1
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    • pp.130-136
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    • 1992
  • Fractures of the tibial shaft are the most common among the long bone fractures, and have much difficulty in treatment due to their enumerous complications. Thirty patients with fractures of the tibial shaft were treated with Ender nails under the image intensifier at the Department of Orthopedic Surgery, Yeungnam University Hospital from December 1986 to November 1991. The following results were observed. 1. The average age was 37.3 years and the number of male was three times of the female. The most common cause was traffic accident. 2. Twenty cases out of thirty one were closed fractrure and the remaining 11 were open. The comminuted and segmental fractures were 18(57.7%) in number and the most common fracture site was the middle one third(53%). 3. Average interval from injury to operation was 7.6 days and 19 cases showed associated injuries. 4. The mean duration of the bone union was 18.9 weeks and 2 cases showed the delayed union. 5. Twelve complications were noted such as shortening, varus deformity, delayed union, ankle motion limitation, nail irritation, and soft tissue infection.

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Treatment of Carpal Scaphoid Fracture (주상골 골절의 수술적 치험례)

  • Beck, Won-Jin;Seo, Jae-Sung;Ahn, Jong-Chul;Ihn, Joo-Chul
    • Journal of Yeungnam Medical Science
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    • v.3 no.1
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    • pp.361-366
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    • 1986
  • Fracture of the carpal scaphoid bone is the most common fracture of the carpus. Unfortunately. nonunion are common since the symptoms do not alert patients to seek early medical treatment and the diagnosis is easily missed. Fracture of the scaphoid is a common condition whose management remains controversial. The conservative treatment has many complications, these include inability to work while in plaster, stiffness of the wrist afterwards, muscle wasting, weakness and malunion. So various operative treatments of scaphoid fracture have been developed. Open reduction by use of screws suggested by Maclaughlin first in 1954. In 1984 a new and simple operative technique has been developed to provide rigid internal fixation for all types of fractures of the scaphoid by T.J. Herbert. This involves the use of a double-treaded bone screw which provides good fixation that, after operation, a plaster cast is rarely required and most patients are able to return to work within a few weeks. Authors have experienced 10 cases of scaphoid fracture and accomplished good result in all cases by internal fixation using Herbert screw. The results are as follows : Of these 10 fractures, 2 were fresh fractures and 8 were non unions of scaphoid fracture. In nonunion cases, the time interval between fracture and operation was from 5 months to 5 years. The postoperative immobilization period was average of 4 weeks. Short period of immobilization achieved early functional recovery of the wrist. The bony unions in roentgenogram were seen from 3 months to 9 months after operation. In 2 cases the fracture gap was seen after 9 months. But in these cases the symptoms such as pain and range of motion of wrist were improved.

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The Clinical Study of the Supracondylar Fracture of the Femur (대퇴골 과상부 골절 및 치료에 대한 임상적 고찰)

  • Ahn, Jong-Chul;Kim, Se-Dong;Ahn, Myun-Whan;Seo, Jae-Sung;Lee, Dong-Chul;Lee, Young-Joo
    • Journal of Yeungnam Medical Science
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    • v.10 no.1
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    • pp.197-211
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    • 1993
  • Recently, the Supracondyle fracture of the femur is so severe and comminuted that it is difficult to treat open reduction and rigid fixation sufficiently due to violent traffic accident and external forces. The associated injuries are accompanied variously. So complications of the supracondyle fractures including joint stiffness, delayed union, infection are serious. However development of internal implant and operation skill result in relatively satisfactory function than conservative management. The authors reviewed 20 cases of the supracondyle fracture of the femur treated at Yeungnam University Hospital from 1989, Dec. To 1992, Jan. The results were as follows : 1. The male was common(70%). The 2nd-4th decade was most(87%). 2. The most common cause of injuries was traffic accident. The rate of open fracture was 35%, most of it was traffic accident. 3. According to the ASIF group classification. 4 cases were type A, 4 in type B, 12 in type C (10 in type $C_2$&$C_3$). 4. Accompanied injuries included multiple fractures in 9 cases and femoral artery injury in 1 case. 5. Among the 20 cases, conservative treatment was done in 5 cases and operative treatment was done in 15 cases. 6. Functional results (by Schatzker criteria) were as follows. The satisfactory results were achieved in 40% of cases in conservative treatment and 67% in operative treatment. 7. The average time of partial weight bearing was 15 weeks. 8. Complications were knee stiffness in 6 cases and 4 in delayed union.

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Arthroscopic Reconstruction of Posterior Cruciate Ligament with Achilles Tendon Allograft (동종 이식 아킬레스 건을 이용한 관절경적 후방 십자 인대 재건술)

  • Kim, Kyung Taek;Sohn, Sung Keun;Lee, Dae Hee
    • Journal of the Korean Arthroscopy Society
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    • v.3 no.1
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    • pp.9-16
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    • 1999
  • Purpose : We have evaluated the outcome of the operative treatment of PCL rupture using the achilles tendon allograft. Materials and Methods : A retrospective study was completed for 30-PCL reconstruction cases, using the achilles tendon allograft from september 1996 to march 1998. There was an average follow up of 24 months, with range of 12 to 50 months. Results : The active range of motion was improved postoperatively. The Lysholm Knee Score was improved from a mean of 54 points preoperatively to 87 points postoerative 18 months. The "Cybex 340 isometric test" revealed satisfactory results compared with autograft. Conclusions : Use of allograft for recostruction of the PCL is an attractive option because it precludes the harvesting of autogenous tissue in a knee that is already at risk for patellofemoral and tibiofemoral osteoarthrosis.

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Outcomes of Lateral Malleolar Saving versus Sacrificing Procedure in Transfibular Ankle Arthrodesis (경비골 도달법을 이용한 족관절 유합술 시 외과의 보존과 희생 방법의 차이에 따른 결과)

  • Chung, Hyung-Jin;Bae, Su-Young;Shin, Yong-Woon;Lim, Dong-Ju;Cho, Sung-Il
    • Journal of Korean Foot and Ankle Society
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    • v.14 no.2
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    • pp.135-139
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    • 2010
  • Purpose: We analyse and report the result of transfibular ankle arthrodesis using lateral malleolar saving procedureversus lateral malleolar sacrificing procedure. Materials and Methods: Eighteen cases of transfibular ankle arthrodesis which were performed since 2001 were included. We devided them into lateral malleolar saving and lateral malleolar sacrificing groups. We reattached and fixed lateral malleolus in 10 cases and sacrificed malleolus for morcelized bone graft in 8 cases. We evaluated clinical results by AOFAS ankle-hindfoot score, visual analogue scale (VAS) and radiological results by union time. Complications and subjective satisfaction degrees were also recorded and compared between two groups. Results: Preoperative mean AOFAS score was 32 points (16~41) and VAS was 7.5 points (7~8) and they were changed into 68.6 points (61~77) and 2.8 points (2~4) postoperatively. There was no significant difference in clinical results between the two groups even though lateral malleolar saving group showed higher AOFAS score (69.4) than lateral malleolar sacrificing group (67.7). Duration of getting union was 11.3 weeks in lateral malleolar saving group and 10.6 weeks in lateral malleolar sacrificing group. There was no difference in subjective satisfaction level. There were one delayed union and one nonunion in lateral malleolar sacrificing group and one nonunion in lateral malleolar saving group. Conclusion: There was no difference in clinical and radiological results between lateral malleolar saving group and lateral malleolar sacrificing group of transfibular ankle arthrodesis. Therefore it may not necessary to sacrifice lateral malleolus for bone graft except very selective case for which heavy graft is needed.

Short Term Result of Total en Bloc Spondylectomy in Spine Tumor (원발성 및 전이성 척추종양에 대한 전 척추 절제술의 단기 추시 결과)

  • Kim, Jae-Do;Jang, Jae-Ho;Park, Chan-Jae;Chung, Jae-Yoon
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.37-42
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    • 2007
  • Purpose: Because of the anatomical characteristics, it is difficult to perform radical operation in spinal tumor. Numerous operations on primary and metastatic spinal tumor have been performed and among those total en bloc spondylectomy has produced decent clinical result. Clinical and radiological results have been analyzed based on five total en bloc spondylectomy on primary and metastatic spinal tumor. Materials and Methods: Patients included in this study were one with primary and four with metastatic spinal tumors, from June 1997 to January 2006. Two of the four were originated form kidney. One was from breast and the other one was not identified. McAfee's 4 point scale, VAS and Frankel's classification have been used as clinical assessment of pain and neurological symptoms. Clinical assessment have been conducted for every 3 months after operation including local recurrence, bone union and complications. Results: Assessment of pain decreased from average of 3 before operation to 1.6 after operation in McAfee's scale and VAS decreased from average of 9.2 to 1.6. Neurological deficit after operation improved from C to D in Frankel's category. Local recurrence has been detected on metastatic adenocarcinoma of L4 during follow up. Conclusion: Total en bloc spondylectomy is evidently useful operational method for primary and metastatic spinal tumor since it completely decompresses spinal nerves, decreases axial pain immediately and improves the quality of remaining life.

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Differences in Associated Shoulder lesions Regarding Ages and Gender Among Patients with Complete Rotator Cuff Tear (회전근 개 완전파열 환자에서의 나이 및 성별에 따른 견관절 동반 병소의 차이)

  • Kim, Jae-Hwa;Dan, Jin-Myoung;Yoon, Byung-Ho;Kim, Young-Woong
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.3
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    • pp.180-184
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    • 2008
  • Purpose: This study evaluated the differences in associated shoulder lesions on complete rotator cuff tear patients regarding ages and gender. Materials and Methods: Between June 2003 and March 2006, 109 patients (59 males, 50 females) who received arthroscopic shoulder surgery for their complete rotator cuff tear were selected and their associated shoulder lesions were analyzed. Ages were between 24 years, the youngest, and 75 years, the oldest. Groups by age were under 59 years group and over 60 years group, and associated lesions of patients to be analyzed were Acromioclavicular arthritis, SLAP(shoulder labrum anterior and posterior) lesion, and biceps tendinitis, and statistic analysis were performed by Khai-square method. Results: For acromioclavicular joint arthritis, over 60 years old group showed higher association rate compared to under 59 years young group, and for SLAP lesions, under 59 years young group showed higher association rate compared to over 60 years old group only in men. Conclusion: For diagnosis and treatment of complete rotator cuff tear patient, associated shoulder lesions in different ages should be considered, especially associations of SLAP lesions in young male patients, and acromioclavicular joint arthritis in old age patients should be verified.

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Treatment of the Soft Tissue Defect in Extremities by Forearm Free Falp (전완부 유리피판술을 이용한 연부조직 결손의 치료)

  • Lee, Kwang-Suk;Byun, Young-Soo;Woo, Kyung-Jo;Bae, Cheol-Hyo
    • Archives of Reconstructive Microsurgery
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    • v.4 no.1
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    • pp.58-64
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    • 1995
  • The radial forearm flap was first designed at the Ba-Ba Chung Hospital of People's Republic of China in 1978. The flap consists of the skin of the volar surface of the forearm, the subcutaneous fat, the underlying fascia, and the intramuscular fascia which includes the radial vessels. It is very useful flap in soft tissue coverage of skin defects of the upper and lower extremities. The authors have reported 13 cases of forearm free flap treated in the Korea University Hospital from January 1991 to Jun 1995 with a review of literature. The results were as follows. 1. We had good results in soft tissue coverage for all patients 2. The average size of flaps was $54cm^2$ and the average ischemic time of flaps was 74minutes. 3. The postoprative complication was occurred in three of 13 cases, two of three cases were arterial thrombosis treated with thrombectomy in postoperative 2 days, and one case was venous thrombosis resulted in superficial necrosis of the flap treated with STSG. 4. Forearm free flap with sensory innervation is a good donor site for reconstruction of weight-bearing areas of heel and sole. 5 The forearm free flap is suitable for soft tissue coverage of the upper and lower extremities, and can be used by skillful microsurgeon with high success rate.

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