• 대한족부족관절학회지
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• 제6권1호
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• pp.7-14
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• 2002

Purpose: We investigate the characteristic morphologic features and suggest proper treatment of postaxial polydactyly of the foot Materials and Methods: We analysed 37 cases of postaxial polydactyly. Mean post operative follow up period was 2 years 10 months. We analysed them according to morphological, radiological and operative findings. Patients were classified into extra 5th toe polydactyly and extra 6th toe polydactyly based on the abnormal extradigit, and subdivided into joint origin type, bone origin type and floating type based on duplication pattern. Results: 23 cases were extra 5th toe polydactyly and 14 cases were extra 6th toe polydactyly. Most common types were metatarsophalangeal joint origin type of extra 6th toe polydactyly. Compared with extra 5th toe polydactyly, extra 6th toe polydactyly originated from more proximal part and had not syndactylism. Conclusion: As the duplication level was more distal, degree of syndactylism and nail union was more severe. In case of syndactyly between 5th and 6th toe, abnormal extradigit was 5th toe.

• 대한치과교정학회지
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• 제28권3호
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• pp.409-417
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• 1998

경희의료원 치과병원 교정과에 내원한 부정교합자 중 전신 건강 상태가 양호한 123명의 좌측 수완부골 방사선 사진을 이용하여, 초경과 골격성숙도간의 상관관계를 연구한 결과 다음과 같은 결론을 얻었다. 1. 초경 발현 연령은 평균 12.31세, 최소 9.6세, 최고 15.6세로 개체간 변이가 심하였다. 2. 초경시 골성숙 상태는 SMI 7,8단계($73\%$), 즉 제5중절골의 골단이 골간을 둘러싸거나 제3말절골의 골간과 골단이 융합되는 단계이며, 초경시의 골격성숙도는 초경 발현 연령에 관계없이 일정하였다. 3. 골성숙단계에 따른 초경 후 경과기간간에는 유의한 차이가 있었다. 4. 요골의 융합은 초경 후 평균 1년 8개월이 지나면 시작되었다. 5.초경 발현 연령에 따른 성장 속도의 비교에서, 만기성숙아(초경을 늦게 경험하는 여아)는 초경 후 14개월이 지나면 요골의 융합이 시작되었고, 조기성숙아(초경을 일찍 경험하는 여아)는 초경후 22개월, 평균성숙아는 초경후 20개월이 지나면 요골의 융합이 시작되었다.

• Clinics in Shoulder and Elbow
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• 제6권1호
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• pp.27-36
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• 2003

Antegrade interlocking intramedullary nailing (AIIN) for the humeral shaft fracture can induce shoulder pain and decrease of shoulder function postoperatively. The purpose of this study was to estimate the outcome of the shoulder functions after AIIN through the rotator interval between the subscapularis and the supraspinatus to decrease the shoulder pain. Out of consecutive 43 cases that underwent AIIN 42 had been followed for two years or more. Among them we analysized 40 cases of 39 Patients excluding two cases of Pathologic fractures. The average was 47 years. There were 17 men and 23 women. The average follow-up was 34 months. Open nailing was performed in 26 fractures and closed nailing in 14. Bone graft was done in 7 fractures with open nailing. With a single operation, all but two patients achieved osseous union. Average pain score with visual analog scale was one (range; 0∼4) postoperatively By the Neer's score 37 patients received a excellent or satisfactory results while 3 patients' unsatisfactory or failed results. By the functional score of ASES (American Shoulder and Elbow Society) 6 cases received the fair or poor results. Except three cases with persistent nerve palsy and one case of technique failure with protruded nail over humeral head, all patients could achieved satisfactory results with Neer's score and 35 cases (94%) satisfactory results with functional score of ASES. An insertion of antegrade nail to the rotator interval was recommended for better shoulder functions and less pain postoperatively.

• Clinics in Shoulder and Elbow
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• 제20권2호
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• pp.95-99
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• 2017

Background: The purpose of this study was to investigate the clinical and radiological outcomes of locking plate fixation with fibular strut allograft to manage unstable osteoporotic proximal humerus fractures. Methods: We retrospectively reviewed 15 patients who underwent open reduction and locking plate fixation with fibular strut allograft for osteoporotic proximal humerus fracture between July 2011 and June 2015. For functional evaluation, we evaluated visual analogue scale (VAS) pain score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) shoulder score, and active range of motion. For radiological evaluation, shoulder true anteroposterior (AP) and AP in $20^{\circ}$ external rotation, as well as the axillary view were taken at two weeks, six weeks, three months, six months, and one year. And the neck-shaft angle was measured on the AP view in $20^{\circ}$ external rotation view. Results: At the one-year follow-up, mean VAS pain score and all shoulder scores, including ASES score and UCLA shoulder score, exhibited satisfactory clinical outcomes. All patients obtained bone union between three and six months post-procedure. Moreover, the mean immediate postoperative neck-shaft angle was $138^{\circ}{\pm}4^{\circ}$, and at one-year follow-up, the neck shaft angle was $137^{\circ}{\pm}5^{\circ}$. There was no significant difference between the preoperative and postoperative values (p=0.105). Conclusions: For the unstable two-part and three-part osteoporotic proximal humerus fractures with medial calcar comminution, the use of fibular strut allograft with locking plate fixation was effective in maintaining the initial status of reduction and exhibiting the satisfactory functional and radiological outcomes.

• Archives of Plastic Surgery
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• 제38권3호
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• pp.287-294
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• 2011

Purpose: Reduction malarplasty is one of the common aesthetic procedures performed in the Orient. We have analyzed effective operative methods according to the pivot point for the osteotomy and reposition of the zygoma for reduction malarplasty after confirming the shapes of the individual zygomas. Methods: Thirty-six patients had been received malarplasty over the last 10 years. The average follow-up period was 16 months. We categorized the patients into three groups according to their prominent appearance features. Group I had a prominently protruded zygomatic body, group II had a prominently protruded zygomatic arch, and group III had a prominently protruded body and zygomatic arch. In the group I, two parallel oblique osteotomies on the body, the middle portion was removed, and with the zygomatic arch as the pivot point, the body was repositioned inwards. In the group II, the zygomatic body and arch osteotomy is performed, with the body as the pivot point, and the arch is depressed medially. In the group III, using the two aforementioned methods, the zygoma was repositioned medially. In each case, postoperative complications and patients satisfaction over the surgery were surveyed. Results: Each group had 25, 5 and 12 patients respectively. No significant complications were found except for one patient who experienced a non-union of zygomatic bone. In the case of group I, four patients underwent a secondary operation. Conclusion: Reduction malarplasty is popular as an effective facial contouring surgery. In order to obtain more effective results,however, the zygomatic shape should be identified, and appropriately repositioned by different operative technique according to pivot points.

• 대한족부족관절학회지
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• 제10권2호
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• pp.150-155
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• 2006

Purpose: The purpose of this study is to assess the results of the autologous osteochondral grafting harvested from medial side of talus for relatively large osteochondral lesion of the medial talar dome. Materials and Methods: From October 2004 to September 2005, 12 patients with osteochondral lesion measured more than 10 mm in axial MRI who were followed up more than 1 year after operation were analyzed. We evaluated postoperative symptoms by Mann and Reynolds scale, morbidity of donor site, and compared the range of both ankle motion. We also evaluated the union at the medial malleolar osteotomy site, trabecular connection between the grafted osteochondral mass and talus, irregularity of the articular surface in lesion. Results: Clinical results were rated as excellent in 4, good in 7, fair in 1. The mean angle of the total range of motion in affected ankle was decreased by 3 degrees compared to that in unaffected ankle. We did not observe abnormal findings at donor site. The osteotomized bone was united at mean 9 weeks (range, 8-12 weeks). We observed trabecular connection between grafted osteochondral mass and talus at mean 14 weeks (range, 12-16 weeks). We also observed irregular articular surface in osteochondral lesions in 6, smooth articular surface in 6. Conclusion: The local autologous osteochondral graft for relatively large osteochondral lesion of the medial talar dome is useful operative method with advantages of wide operative field, low morbidity of donor site, and high satisfaction rate.

• 대한족부족관절학회지
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• 제17권1호
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• pp.28-33
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• 2013

Purpose: In previous study, the frequency of osteoarthritis and discomfort were high in ankle fracture-dislocation but detail results about ankle fracture-dislocation has rarely been investigated. In this study, we retrospectively analyze the outcome of the operative treatment of ankle fracture with dislocation for over-2 years follow up. Materials and Methods: There were 47 cases of ankle fracture-dislocation in our hospital from March 2007 to May 2010. We investigated 20 patients who underwent operation and were possible for over-2 years follow up. The result was estimated with the direction of dislocation, fracture type, the time of bone union and post-traumatic osteoarthritis with plain radiologic images. In clinical assessment, we statistically evaluated the function and pain through AOFAS score and Olerud & Molander scoring system. Results: By Lauge-Hansen classification, there were 13 cases(65%) of pronation-external rotation and 6 cases(30%) of supination-external rotation, 1 case(5%) of supination-adduction. AOFAS score was 85.5, and Olerud & Molander score was "excellent" in 8 cases, "good" in 5 cases, "fair" in 3 cases and "poor" in 4 cases. Postoperative complications in 4 cases revealed post-traumatic arthritis. All kinds of lateral dislocation of ankle fracture was 15 cases and the most common. Of these, all 3 cases, anterolateral dislocation showed post-traumatic osteoarthritis. Conclusion: In ankle fracture-dislocation, post-traumatic osteoarthritis occurred in 4 of 20 patient(20%). Especially, the possibility of post-traumatic osteoarthritis was more in cases of anterolateral or lateral dislocation. So, it must be needed that deliberate examination, for example, preoperative MRI and sufficient explanation to patient. Also, we have to follow up the patients carefully.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제27권5호
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• pp.435-441
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• 2001

Orthognathic surgery for the correction of dentofacial deformities is a common elective procedure. That has proven over the years to be a safe operation with minimal long-term morbidity. But, there are many surgical complication including mal-union of the bone, TMJ problem, excessive bleeding, and permanent damage of inferior alveolar nerve. Among them excessive bleeding which focus is not clear is one of the serious complication because that is fatal and so a transfusion is performing for the prevention and management of that. Until the end of the 1980's, homologous blood transfusions were routinely necessary because of the large amounts of blood lost during surgery. Recently several blood-saving measures can be undertaken for orthognathic surgery patients before, during, and after the operation. We made a comparative study of an amount of blood loss, hematologic change and transfusion requirements based on a series of 40 consecutive patients undergoing single-jaw and double-jaw surgery. The purpose of this investigation was to make a comparative analysis of an amount of blood loss, post-operative hematologic change and duration of the procedure under induced hypotensive anesthesia in healthy orthognathic patients.

• 대한한방소아과학회지
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• 제32권1호
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• pp.30-43
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• 2018

Objectives The purpose of this study is to analyze the clinical research literature of TCM (traditional Chinese medicine) which is applicable to pediatric fracture and to broaden the field about clinical application of Korean medicine treatment for pediatric fracture. Methods We searched randomized controlled trials about TCM treatment of pediatric fracture from the CNKI (China National Knowledge Infrastructure) January 2013 to December 2017. We searched the literature and analyzed the treatment methods and the results. Results 31 papers were selected from 63 studies. In most studies, the total effective rate of the treatment group was significantly higher than that of the control group, and the bone healing time of the treatment group was significantly lower than that of the control group. Methods of herb treatment include internal medicine (IM), fumigation (FG) and external application (EA). The most commonly used herb medicine were Angelicae Gigantis Radix (當歸), Carthami Flos (紅花), Drynaria Fortunei (骨碎補), Paeonia Lactiflora Pallas (芍藥), Persicae Semen (桃仁), Lycopodii Herba (伸筋草), Ligusticum Chuanxiong Hort (川芎), Olibanum (乳香), Salviae Miltiorrhizae Radix (丹蔘), and Panax Noto Ginseng (三七). Conclusions The use of herb medicine in pediatric fractures has resulted in faster and more effective restoration of fracture union than the Western medical therapy alone. Based on the results of this study, it is possible to widen the scope of Korean medicine if additional clinical studies on pediatric fracture were conducted.

• 대한족부족관절학회지
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• 제7권2호
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• pp.151-156
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• 2003

Purpose: Proximal crescentic metatarsal osteotomy(PMO) is one of the most common procedures for correcting moderate to severe degree hallux valgus deformity. Although screw fixation is used for osteotomy site stability, loss of reduction can occur. The purpose of this study is to compare the sagittal plane stability of the conventional crescentic PMO fixed with a single screw with that of the crescentic PMO fixed with 1 screw and 2 supplemental K -wires. Material and Methods: Ten matched pairs of cadaveric foot specimens were used for the proximal crescentic metatarsal osteotomy. For one foot specimen of each pair, crescentic osteotomy was fixed with 4mm long threaded cannulated screw, while the matched pair was prepared by adding two axial 1.6mm K-wires to the conventionally fixed 4mm screw. The extensometer was used to measure the osteotomy gap as the metatarsal head was loaded continuously until failure using a servohydraulic MTS Mini Bionix test frame. The strength of fixation was normalized with the bone mineral density (BMD) of the paired specimen $(N{\times}cm^{2}/gm)$, Result: The average strength of the crescentic PMO with axial K-wire fixation ($458.8cm^{2}/gm$, S.D. 434.3) was significantly higher than the standard crescentic PMO ($367.5cm^{2}/gm$, S.D. 397,9) (p=0.05). Conclusion: Supplemental fixation with two axial K-wires can be added to the crescentic PMO to enhance the initial fixation stability to prevent the loss of reduction or dorsal malunion.