• Archives of Plastic Surgery
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• 제33권4호
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• pp.480-484
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• 2006

Purpose: A lot of surgical techniques were tried to correct extension lag of distal interphalangeal joint. Spiral oblique retinacular ligament reconstruction is the one of correction techniques. Methods: From January 2004 to January 2005, a total of 13 extension lag of distal interphalangeal joint corrections were performed using spiral oblique retinacular ligament reconstruction for 11 patients. After dorsal incision exposing from base of distal phalanx to proximal phalanx, the new ligament(half of lateral band or graft tendon) lies distally at the dorsum of the distal phalanx and passes volarly and proximally along the side of the middle phalanx and anterior and obliquely across the front of the proximal interphalangeal joint to the opposite side of the digit at the proximal phalanx. Results: 5 of 6 mallet finger deformities and 7 swan neck deformities were corrected, which were both extension lag of distal interphalangeal joint and hyperextension of proximal interphalangeal joint. Conclusion: As a result, spiral oblique retinacular ligament reconstruction is an effective and recommendable method for correction of mallet finger deformity and swan neck deformity.

• 대한정형외과스포츠의학회지
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• 제3권2호
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• pp.134-140
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• 2004

목적: 불안정성 무지수근중수관절의 손상을 가진 환자에서 전방사상 인대의 재건술을 권장하고 있다. 전방사상 인대손상을 요측수근굴근건을 이용해 치료받은 2명의 환자들의 기능적 결과를 후향적 연구하고자 하였다. 대상 및 방법: 전방사상인대 파열로 대능형중수관절의 불안정성을 지닌 2명의 환자가 요측수근굴건이식을 통해 재건술을 시행받았고 이환자들을 2년간 추시 분석하였다. 결과: 2년후의 추시 결과는 이들 모두 상당한 통증과 증상의 완화를 보였다. 건측에 비해 악력은 90$\%$로 회복되었다. 환자들은 주관적인 호전을 보였으며 "만약 이처럼 다친다면 다시 이러한 수술을 받을 것이다."라고 말했다. 결론: 이러한 손상에 대한 향상된 지식 을 통해 조기 진단과 정확한 진단이 가능해 환자가 적절히 처치될 수 있을 것이다.

• 대한정형외과학회지
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• 제55권4호
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• pp.311-317
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• 2020

전방십자인대 재건술에 있어서 최근 가장 각광받고 있는 개념은 해부학적 전방십자인대 재건술이다. 경경골 술식을 이용한 고전적인 방법에 비하여 해부학적 재건술을 위해서 경골터널은 이전보다 전방으로 이동하며 대퇴터널은 낮고 비스듬한 방향으로 만들게 된다. 따라서 낮고 비스듬한 해부학적인 위치의 대퇴터널을 만들기 위하여 전내측 도달법을 통한 술식(anteromedial portal technique), outside-in 술식, 그리고 변형된 경경골 술식(modified transtibial technique) 등이 시행되고 있다. 각각의 방법은 장단점이 있어 술자의 선호도, 경험, 사용 가능한 기구 및 이식건의 선택 등에 따라 선택된다.

• Journal of Korean Neurosurgical Society
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• 제29권11호
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• pp.1461-1468
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• 2000

Objective : The aim of this study is to evaluate clinical outcome of anterior screw fixation for type II odontoid fractures for the prliematim of atlanatoaxial mobility. Methods : Between 1995 and 1999, we treated 15 cases of type II odontoid fractures by anterior screw fixation among 44 cases of odontoid fractures. Thece included 14 males and 1 female aged from 23 to 63 years, with a mean age of 39.7 years. The causes of trauma were traffic accident in 13 cases, slip down in 1 and fall down in 1. The fracture type was type II-P in 7 cases, type II-A in 3, type II-N in 2 and type II-A and P in 3. The fracture line was oblique downward and backward in 6 cases, oblique downward and forward in 3 and horizontally in 6. The range of follow up was 4 to 47 months(mean 26.5 months). Results : Adequate reduction and fixation were obtained in 12 cases. Three cases in which fracture type and line were type II-A and oblique downward forward were failed, so posterior transarticular screw fixation was performed. All except 3 failed cases had adequate cervical movement and stability. There were no operative mortality nor morbidity. Conclusion : Anterior screw fixation provides the best anatomical and functional results for type II odontoid fracture with intact transverse ligament when fracture line is horizontal or oblique downward and backward. But it is limited when fracture line is oblique downward and forward.

• Journal of Korean Neurosurgical Society
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• 제37권5호
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• pp.345-349
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• 2005

Objective: Anterior screw fixation provides the best anatomical and functional results for type II odontoid process fracture (type II-A, II-N, and II-P) with intact transverse ligament. The purpose of this study is to evaluate the usefulness of the 4.5mm diameter, cannulated Herbert screw in anterior screw fixation. Methods: From Jan. 2003 to Feb. 2004, consecutive 10cases of type II odontoid process fractures were treated with anterior screw fixation using a Herbert screw. The Herbert screw has double threads, with different pitches on the distal and proximal ends. It has no head, so it can be inserted through articular cartilage and buried below bone surface. It was originally developed for treating scaphoid fractures. Results: There were 8male and 2female patients whose ages ranged from 15 to 67years (mean 42.1years). The fracture type was type II-A in 4patients, II-N in 3 patients, and II-P in 3 patients. The fracture line was oblique downward and backward in 6cases, oblique downward and forward in 1 case, and horizontal in 3cases. The range of follow-up was 5 to 18months (mean 12months). Bone fusions were achieved in all cases without any instrumental failures or postoperative complications. Conclusion: The Herbert screw is very useful in anterior fixation for type II odontoid process fracture. This series showed successful results also in type II-A odontoid fracture when treated with the Herbert screw, but further more studies are required.

• 대한관절경학회지
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• 제16권1호
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• pp.17-25
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• 2012

목적: 급성 전방십자인대 손상 환자의 자기공명영상(magnetic resonance imaging, MRI)에서 나타난 골멍의 형태 및 크기와 전방십자인대의 손상 정도와의 관계를 알아보고 골멍의 발자취(footprint)를 조사해 손상기전을 알아보고자 하였다. 대상 및 방법: 급성 전방십자인대 손상 6주 이내의 급성기에 자기공명영상을 촬영하여 골멍이 나타나는 65명을 대상으로 하였다. 골멍의 형태는 Costa-Paz 분류에 따라, 골멍의 크기는 Kornaat의 방식으로 측정하였다. 자기공명영상의 전방십자인대 관상사면영상(anterior cruciate ligament [ACL] oblique coronal view)에서 손상 정도를 등급화 하였다. 결과: Costa-Paz 분류에 따른 대퇴골 외과의 골멍 형태와 전방십자인대 손상 정도의 관계를 알아본 결과, 부분 파열군(1, 2 등급)에서 제2형이 많고, 완전 파열군(3 등급)에서 제3형이 많았다(P=0.037). Kornaat 총 골멍 점수는 전방십자인대 손상 등급에 따라 차이를 보였으며(P=0.014), 손상기전은 축회전 손상(pivot shift injury)이 가장 많았고 편타 외반 손상 (clip valgus injury) 등이 뒤를 이었다. 결론: 급성 전방십자인대 손상 시 골멍의 형태와 크기는 전방십자인대의 손상 정도와 관련이 있었고, 골멍의 발자취를 통해 손상기전을 유추할 수 있어 급성 전방십자인대 손상의 진단 및 치료에 도움이 되리라 사료된다.

• 대한관절경학회지
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• 제12권2호
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• pp.118-124
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• 2008

Purpose: Recent development and advances in the arthroscopic surgical techniques for anterior cruciate ligament(ACL) reconstruction have led to the ideal location for more oblique anatomic point of the femur from 10 to 10:30 o'clock(in the right knee) and from 2 to 1:30 o'clock(in the left knee) in the frontal plane. This study was performed to compare the operative methods and the radiologic results of the femoral tunnels made through the tibial tunnel(trans-tibial approach) and the anteromedial portal. Materials and Methods: From January 2003 to May 2004, on hundred reconstructions of ACL were performed. Group I(the femoral tunnel made through the tibial tunnel) consisted of 50 cases and group I(the femoral tunnel made through the anteromedial portal) consisted of 50 cases. The operative methods and the radiographic results of the femoral tunnels were compared. Results: Femoral tunnel was made more easily at more oblique anatomic point in group II than in group I. In group II, better visual field was achieved at the angle of 100? flexion of the knee joint, the risks of the posterior cortical breakage and the tunnel-graft mismatching were reduced more, and the divergence of femoral interference screw from the radiograph decreased more than in group I(p<0.05). The angle between the femoral tunnel and the longitudinal axis of ACL increased in group II. Conclusion: Anteromedial portal technique was useful for femoral tunneling toward 10 to 10:30 o'clock(in the right knee) and 2 to 1:30 o'clock(in the left knee) in ACL reconstruction. Level of Evidence:Level III, case-control study.

• 대한방사선기술학회지:방사선기술과학
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• 제23권1호
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• pp.21-27
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• 2000

To evaluation of patients who have shoulder impingement syndrome is by diagnostic radiography. Shoulder impingement is a problem which occurs in young, active individuals as well as older individuals. In fact, the pain is probably caused by repetitive stress placed on the shoulder joint either through recreational activities of your occupation. Impingement series approach to radiographic examination of the shoulder is take five projections. First anteroposterior oblique projection. Second standard anteroposterior projection. Third superoinferior axial projection. Fourth supraspinatus outlet projection offers a view of the outlet of the supraspinatus tendon unit as it passes under the coraacromial arch. Fifth anteroposterior $30^{\circ}$ caudal projection will adequately demonstrate the anterior acromial spur or ossification in the coraacromial ligament and more reliable to demonstrate spurring of the anterior acromion than supraspinatus outlet projection. This decreased the need for additional radiographic veiws, reduces the patient's exposure to x - ray radiation and decreases use of film. This can lower the cost of the evaluation and improve patient satisfaction.

• 대한관절경학회지
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• 제12권2호
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• pp.112-117
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• 2008

목적: 이중 다발을 이용한 전방십자인대 재건술은 등장성과 해부학적 기능을 회복할 수 있다는 장점이 있다. 본 연구는 전방십자인대 손상 환자에서 부가적인 전내측 입구를 통한, 자가 슬괵건을 이용한 이중 다발 재건술의 임상적 결과를 평가하고자 한다. 대상 및 방법: 2005년 1월부터 2006년 7월까지 자가 슬괵건(hamstring tendon)을 이용하여 이중 다발 전방십자인대 재건술을 시행한 60예(남자: 52예, 여자: 8예)를 대상으로 하였다. 평균 나이는 31.7세($20{\sim}51$세)였다. 평균 추시 기간은 13.4개월($12{\sim}16$개월)이었다. 슬관절의 경골 조면 부위에서 수평 사위(horizontal-oblique)의 피부 절개를 시행하여 반건양건(semitendinosus tendon)과 박건(gracilis tendon)을 얻었다. 후외측 다발을 위한 경골 터널은 해부학적인 위치에 만들었다. Yasuda 등이 보고한 방법을 변형하여, 후외측 다발을 위한 대퇴골 터널은 부가적인 전내측 입구를 통하여 만들었다. 전내측 다발에 대하여는 통상적인 방법으로 터널을 만들었다. 후외측 다발은 박건을, 전내측 다발은 반건양건을 사용하였다. 최종 추시시 관절 운동범위, 전방 전위 정도(KT-1000 관절계), pivot-shift 검사로 임상 결과를 평가하였다. 슬관절의 기능적 평가는 Lysholm score와 modified Feagin Scoring System를 측정하였다. 결과: 최종 추시시 관절 운동 범위 제한은 없었다. KT-1000 관절계를 이용한 정상측과의 비교에서 경골 전방 전위가 술전 평균 8.4 mm에서 술후 평균 1.7 mm로 향상되었다(p<0.05). Lysholm score는 술전 평균 64.1점에서 술후 평균 92.2점으로 향상되었다(p<0.05). Modified Feagin Scoring System에 의한 기능 평가에서는 90%에서 우수 이상의 결과를 보였다. 결론: 부가적인 전내측 입구를 통한, 자가 슬괵건을 이용한 이중 다발 전방십자인대 재건술은 우수한 임상 결과를 보였다.

• 대한한의학회지
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• 제32권3호
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• pp.1-9
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• 2011

Objectives: This study was carried out to observe the foot gworeum meridian muscle from a viewpoint of human anatomy on the assumption that the meridian muscle system is basically matched to the meridian vessel system as a part of the meridian system, and further to support the accurate application of acupuncture in clinical practice. Methods: Meridian points corresponding to the foot gworeum meridian muscle at the body surface were labeled with latex, being based on Korean standard acupuncture point locations. In order to expose components related to the foot gworeum meridian muscle, the cadaver was then dissected, being respectively divided into superficial, middle, and deep layers while entering more deeply. Results: Anatomical components related to the foot gworeum meridian muscle in human are composed of muscles, fascia, ligament, nerves, etc. The anatomical components of the foot gworeum meridian muscle in cadaver are as follows: 1. Muscle: Dorsal pedis fascia, crural fascia, flexor digitorum (digit.) longus muscle (m.), soleus m., sartorius m., adductor longus m., and external abdominal oblique m. aponeurosis at the superficial layer, dorsal interosseous m. tendon (tend.), extensor (ext.) hallucis brevis m. tend., ext. hallucis longus m. tend., tibialis anterior m. tend., flexor digit. longus m., and internal abdominal oblique m. at the middle layer, and finally posterior tibialis m., gracilis m. tend., semitendinosus m. tend., semimembranosus m. tend., gastrocnemius m., adductor magnus m. tend., vastus medialis m., adductor brevis m., and intercostal m. at the deep layer. 2. Nerve: Dorsal digital branch (br.) of the deep peroneal nerve (n.), dorsal br. of the proper plantar digital n., medial br. of the deep peroneal n., saphenous n., infrapatellar br. of the saphenous n., cutaneous (cut.) br. of the obturator n., femoral br. of the genitofemoral n., anterior (ant.) cut. br. of the femoral n., ant. cut. br. of the iliohypogastric n., lateral cut. br. of the intercostal n. (T11), and lateral cut. br. of the intercostal n. (T6) at the superficial layer, saphenous n., ant. division of the obturator n., post. division of the obturator n., obturator n., ant. cut. br. of the intercostal n. (T11), and ant. cut. br. of the intercostal n. (T6) at the middle layer, and finally tibialis n. and articular br. of tibial n. at the deep layer. Conclusion: The meridian muscle system seemed to be closely matched to the meridian vessel system as a part of the meridian system. This study shows comparative differences from established studies on anatomical components related to the foot gworeum meridian muscle, and also from the methodical aspect of the analytic process. In addition, the human foot gworeum meridian muscle is composed of the proper muscles, and also may include the relevant nerves, but it is as questionable as ever, and we can guess that there are somewhat conceptual differences between terms (that is, nerves which control muscles in the foot gworeum meridian muscle and those which pass nearby) in human anatomy.