• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 1999년도 학술대회
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• pp.69-69
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• 1999

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2005년도 제13차 춘계학술대회
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• pp.66-66
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• 2005

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2008년도 제16차 학술대회
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• pp.108-108
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• 2008

• Journal of Chest Surgery
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• 제17권1호
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• pp.110-117
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• 1984

A clinical evaluation was performed on 76 cases of chest injury experienced at department of Chest Surgery, Capital Armed Forces General Hospital during the past 3 years period from January 1981 to August 1983. 1.The most common cause of the chest trauma was gun shot by which 26 cases were injured among 44 cases [57.9%] of penetrating injury. Remaining 32 cases [42.1%] were injured by non-penetrating blunt trauma. 2.Hemopneumothorax was observed in 60 cases [78.9%], those were caused by both penetrating [65%] and non-penetrating [35%] injuries. 3.Rib fracture was found in 58.7% of total cases and with rib fracture, clavicle fracture was combined at 19.6% and sternal fracture, at 8.7%. 4.Most common symptoms were chest pain and dyspnea, and most common signs were breath sound diminution and subcutaneous emphysema. 5.Common site of rib fracture was from 4th rib to 8th rib [69.4%]. 6.In 58 cases [76.3%], patients were treated with operation including open thoracotomy [25 cases]. 7.Overall mortality was 5.3%[4 cases] and causes of death were septic shock and respiratory failure.

• Clinics in Shoulder and Elbow
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• 제19권1호
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• pp.25-32
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• 2016

Background: The goal of this study was to evaluate whether a modified fluoroscopic technique for positioning a hook plate affected the clinical results of treating Neer type II distal clavicle fractures and Rockwood type V acromioclavicular (AC) joint separations with this device. Methods: The study was a retrospective consecutive case series with data analysis. Sixty-four patients with a Neer type II distal clavicle fracture or a Rockwood type V AC joint injury treated between March 2009 and June 2013 were divided into 2 groups: traditional fluoroscopic technique (traditional view, 31 patients) or modified fluoroscopic technique ('hook' view, 33 patients). A visual analogue scale (VAS) score, the modified University of California-Los Angeles (UCLA) shoulder scale score, and radiographic osteolysis were the main outcome measures. Results: The traditional group included a significantly larger number of patients with acromial osteolysis than the hook view group: 23 patients (74.2%) vs. 11 patients (33.3%), respectively (p=0.01). Before plate removal, the hook group reported less pain and higher UCLA shoulder scale scores than the traditional group: average VAS score, 1.55 vs. 2.26, respectively; average UCLA score, 30.88 vs. 27.06, respectively. However, there was no significant difference after plate removal. Conclusions: The hook view allows more accurate bending of the hook plate around the contour of the acromion, resulting in decreased osteolysis, decreased pain, and better function with the plate in situ.

• Clinics in Shoulder and Elbow
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• 제1권1호
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• pp.132-137
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• 1998

환자 및 아버지의 cafe-au-leit반점으로 유전적 소인을 인정할 수 있는, 쇄골의 저성장 및 미란성 변화를 동반한 신경섬유종증 1례를 치험한 바, 상기 환자의 골격계의 변형이 신경섬유종증의 골막침범에 의한 압박 및 그로 인한 영양효과(trophiceffect)로 인한 것임을 확인할 수 있었다.

• Journal of Trauma and Injury
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• 제22권1호
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• pp.37-43
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• 2009

Purpose: A missed fracture is a very common occurrence in the Emergency Department (ED) and can have serious results because of delays in treatment, resulting in long-term disability. It is also one of the most common causes leading to medical legal issues. We analyzed the causes of missed fractures by using a bone scan which is known to be an effective tool for diagnosing bony lesions. Methods: We reviewed the medical records of trauma patients who underwent a bone scan after being discharged the ED from September 2006 to March 2008. Cases of missed fractures were identified by using electronic medical records to review each diagnosis. Definition of missed fracture was read after bone scan by radiologist. We decided that there was no fracture if we read 'trauma-related lesion' or 'cannot rule out fracture' on a bone scan read by a radiologist. Enrolled patients were analyzed by age, sex, time until bone scan and Injury Severity Score (ISS). Patients were divided into two groups, alert mentality and not-alert mentality, so there were split between a diagnosis group and a missed fracture group. ISS was also used in determining the severity of the patient's injury upon discharge from the ED. Results: A total of 532 patients were enrolled in this study. Of those, 487 patients were in the diagnosis group, and 45 patients (8.4%) were discovered to have had a fracture. Of the 45 missed fracture patients, 34 patients (6.4%) had one-site fractures, 8 patients (1.5%) had two-site fractures, and 3 patients (0.6%) had three-site fractures. The most commonly missed fracture was multiple rib fractures (18 patients, 30.5%), followed by lumbosacral (LS) spine fractures (10 patients, 16.9%), thoracic spine fractures (8 patients, 13.6%), and clavicle fractures (6 patients, 10.2%). Mean age was $50.12{\pm}18.54$ years in the diagnosis group and $57.38{\pm}16.88$ years in the missed fracture group. For the diagnosis group, the mean ISS was $9.03{\pm}8.26$, but in the missed fracture group it was $17.53{\pm}9.69$. Missed fractures were much more frequent in the not-alert mentality (p<0.01) and in the high (ISS$ ISS{\geq}16$) group (p<0.01). Conclusion: Missed fractures occur most frequent in patients of old age, not-alert mentality, and high ISS. Multiple rib and spine fractures were found to be the most frequent missed fractures, regardless of trauma severity. This study also shows a high possibility of clavicle and scapula fractures in patients with severe trauma.

• Clinics in Shoulder and Elbow
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• 제14권1호
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• pp.59-66
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• 2011

목적: 견쇄관절의 손상이나 원위 쇄골 골절의 치료에 대해서는 많은 연구가 있으나, 견쇄관절 손상을 동반한 원위 쇄골 골절의 치료에 대해서는 알려진 바가 적다. 저자들은 견쇄관절의 손상을 동반한 원위 쇄골 골절의 수술적 치료 및 결과, 예후를 평가하고자 한다. 대상 및 방법: 견쇄관절의 손상을 동반한 쇄골 외측단에서 2.5 cm 내를 침범한 원위 쇄골 골절로 수술적 치료를 받은 21명 (21예)의 환자를 대상으로 후향적 연구를 시행하였다. 단순 방사선 사진과 CT상 원위 쇄골의 골절선이 견쇄관절로 연장 (5예)되어 있거나, 7 mm 이상의 견쇄관절의 이개 (separation)가 있는 관절내 골절 (9예), 또는 건측과 비교해서 50% 이상 원위 쇄골의 상방전위가 있는 관절내 골절 (7예)을 견쇄관절의 손상이 있는 경우로 분류하였다. Craig 분류상 III형이 16예, V형이 5예였다. 금속판 (9예), 소형나사 (1예), K 강선 및 긴장대 강선 (10예) 및 경 견쇄관절 K 강선 (1예)을 사용하여 골절을 고정하였다. 건측에 비해 100%이상 원위 쇄골의 상방전위가 있었던 1예 및 골편이 작아 고정력이 약하다고 판단된 1예에서 경 견쇄관절(transarticular AC joint) K 강선 고정을 추가적으로 실시하였다. 견봉 쇄골 인대 또는 오구 쇄골 인대의 봉합이나 재건술은 시행하지 않았다. 결과: 21예 중 20예에서 골유합을 얻었으며 골유합까지의 기간은 평균 8.4주이었다. 최종 추시시 5예에서 견쇄관절의 외상성 관절염이 관찰되었고, 4예에서 견쇄관절의 이개가, 2예에서 건측과 비교하여 50% 이하의 상방전위가 남아 있었으나 견쇄관절의 이개 및 상방전위가 술전보다 증가된 예는 없었다. Kona 등의 기준에 따른 기능적 평가상 19예에서 우수, I예에서 양호, 1예에서 보통의 결과를 얻었다. 견쇄관절 손상의 분류에 따른 UCLA 점수는 I형에서 32.6점, II형에서 34점, III형에서 34.1점이었다. 술전 견쇄관절 손상 종류, 술후 잔여 관절의 이개 및 전위, 외상성 관절염의 유무와 임상 결과간에 유의한 연관성은 관찰되지 않았다 (p>0.05). 합병증으로는 K 강선 및 긴장대 강선 고정술로 고정한 1예에서 불유합이 관찰되어 술후 3개월 금속판 고정술 및 골이식술을 시행하여 골유합을 얻었으며, 금속판 고정술을 시행한 1예에서 추시 관찰 중 내고 정물의 이완이 있었으나 추가적인 치료 없이 골절이 유합되었다. 결론: 견쇄관절로 연장된 골절이 있거나 관절내 골절이 있으면서 견쇄관절 간격이 7 mm 이상 벌어진 경우 또는 정상측과 비교하여 50% 이상 원위 쇄골의 상방전위가 있는 견쇄관절의 손상이 동반된 경우라도 원위 쇄골의 정확한 정복과 견고한 내고정을 통해 만족할 만한 결과를 얻었다. 수술 전 견쇄관절의 손상 종류 및 수술 후 경도의 외상성 관절염이나 이개, 상방전위와 임상적 기능 사이에 유의한 연관성은 없었다.

• Journal of Chest Surgery
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• 제14권2호
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• pp.123-126
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• 1981

190 cases of the thoracic injuries experienced at the department of chest surgery, Chungnam National University Hospital, for 5 years from Jan. 1976 till Dec 1980, were analysed. The results are as follows; 1. The incidence rate of male to female was 5.1:1. The common age groups were 3rd, 4th and 5th decades, and the most common age group in the penetrating injury was 3rd decade. 2. The most common mode of the nonpenetrating injuries was a traffic accident [63.0%], and the most commonly used tool in the penetrating injuries is a knife [66.7%]. 3. The most common nonpenetrating injury was rib fracture [73.9%], and the common fracture sites were 5th, 6th, 7th and 8th ribs [especially, 7th rib]. The incidence rate of flail chest was 15% of the cases of the rib fractures. 4. The common associated injuries of the nonpenetrating were long bone fracture [18.3%], brain contusion [15.9%], and clavicle fracture etc.. 5. The common method of surgical treatment were closed thoracostomy [46.7%], thoracentesis, and open thoracotomy [7.4%] etc.. 6. The overall mortality was 2.8%. [Nonpenetrating; 0.8%, Penetrating; 6.3%]

• Clinics in Shoulder and Elbow
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• 제17권1호
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• pp.36-39
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• 2014

Clavicular hook plate is known to be an effective treatment on acromioclavicular (AC) joint injury, but there have been some reports of complications, like osteolysis and bony erosion of the undersurface of acromion. Fifty-five year old male underwent open reduction and hook plate insertion on Rockwood type 5 acromioclavicular joint dislocation. He complained of protrusion of posterior acromion at 1 month after the surgery, and acromial fracture was noted in simple radiographs. The hook plate was removed and any other treatment for osteosynthesis was refused by the patient. At the 18 months after the surgery, the patient had no pain and a full range of motion with no tenderness around the shoulder joint. After two years, plain radiographs revealed complete bony union of the acromion fracture.