• 제목/요약/키워드: Fibular

검색결과 210건 처리시간 0.02초

만성 족관절 외측 불안정성의 관절경적 소견 및 치료 (Arthroscopic Findings and Treatment of Chronic Lateral Ankle Instability)

  • 이승용;김갑래;박덕용
    • 대한족부족관절학회지
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    • 제11권2호
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    • pp.198-203
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    • 2007
  • Purpose: To assess the arthroscopic findings in chronic lateral ankle instability and to evaluate the results of modified $Brostr{\ddot{o}}m$ operation and arthroscopic procedures. Materials and Methods: Twenty-nine cases with chronic lateral ankle instability were treated with modified $Brostr{\ddot{o}}m$ operation and ankle arthroscopy from May 2004 to January 2007. There were 19 male and 10 female with the mean age of 29.7 years. Mean follow up period was 15.8 months. All patients were checked preoperative stress anterior drawer and varus test with X-ray. Results: Associated injuries were 28 fat impingement projected into the joint between distal tibio-fibular space, 20 anterior impingement of soft tissue, 19 osteochondral defects and 13 loose body. Preoperative AOFAS score of pain, function and alignment were 28.9, 34.1 and 7.9 each other. They were improved into 38.7, 40.8 and 9.8 postoperatively. Conclusions: Modified $Brostr{\ddot{o}}m$ operation with ankle arthroscopy for chronic lateral ankle instability is believed to be a reliable option to obtain satisfactory results. Careful attention to the associated injuries such as distal fat impingement, anterior impingement, osteochondral defect and loose body is needed during the arthroscopy.

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원위 요골에 발생한 거대 세포종의 일괄 절제 후 초고분자량 폴리에틸렌 삽입물을 이용한 재건술 - 증례보고 - (Reconstruction of Distal Radius Using Ultrahigh Molecular Weight Polyethylene Liner after Excision of Giant Cell Tumor - A Case Report -)

  • 전대근;송원석;오정문
    • 대한골관절종양학회지
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    • 제10권1호
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    • pp.29-33
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    • 2004
  • 원위 요골의 거대 세포종은 빈도가 많지는 않다. 통상적으로 골 소파술 및 골 시멘트 충전술로 치료하지만, 재발한 경우나 처음부터 골피질 파괴가 심하고 관절 침범이 있을 경우에는 일괄 절제(en bloc resection) 후 근위 비골을 이용하여 재건하는 술 식이 많이 이용되어 왔다. 본 연구는 고식적 술 식으로 치료한 후 국소 재발한 원위 요골의 거대 세포종 환자에서, 근위 비골을 이용한 재건술을 시행하여도 일차 술 식 시 오염의 범위가 심하여 다시 재발할 가능성이 높아 초고분자량 폴리에틸렌(ultrahigh molecular weight polyethylene, UHMWPE)과 골수강내 고정물 및 골 시멘트를 조합하여 원위 요골을 재건한 1례를 보고 하고자 한다.

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MIPPO 수기를 이용한 원위 경골 골간단 골절의 치료 (Treatment of Distal Tibial Metaphyseal Fracture Using MIPPO Technique)

  • 이호승;김정재;오세관;안형선
    • 대한족부족관절학회지
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    • 제8권2호
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    • pp.166-170
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    • 2004
  • Purpose: To evaluate the results of MIPPO (minimal invasive percutaneous plate osteosynthesis) technique for distal tibial metaphyseal fractures. Materials and Methods: It is a retrospective study of 13 patients who were treated by MIPPO technique for distal tibial metaphyseal fractures from Jan. 2001 to Jan. 2003. The average age was 46.7 years and mean follow-up period was 13.3 months. According to AO classification, there were 8 cases of A1, 3 cases of A2, 1 case of B1 and 1 case of C2. One case of A1 was a Gustilo-Anderson type I open fracture and fibular fractures were combined in 12 cases. We applied anatomical reduction and internal fixation for the fibular fractures and internal fixation on the medial side of the tibia by MIPPO technique for distal tibial metaphyseal fractures. Clinical results were evaluated using radiographic results, Neer score, the starting time of postoperative exercise and clinical complications. Results: According to the Neer score, all cases showed satisfactory results. Active ankle ROM was started at average 2.4 weeks ($2{\sim}4$ weeks) and full weight bearing ambulation at average 5.2 weeks ($4{\sim}8$ weeks) postoperatively. Union of fractures was obtained by average 14.4 weeks ($8{\sim}18$ weeks) postoperatively. Two cases showed $5^{\circ}$ limitation of motion without functional deficits and other cases showed satisfactory ROM results. One case had $6^{\circ}$ valgus deformity without functional deficits. There were not any other complications like soft tissue problems and delayed-or non-union. Conclusion: MIPPO technique for the treatment of distal tibial metaphyseal fractures is a feasible technique with a good clinical outcomes.

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하악골 법랑질모세포종의 분절 하악절제술 후 하악 재건 및 치아 임플란트 시술 (Mandibular Reconstruction and Dental Implantation after Segmental Mandibulectomy of Ameloblastoma of the Mandible)

  • 서승조;이일재;이정근;임효섭;김치선;박명철
    • Archives of Plastic Surgery
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    • 제38권2호
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    • pp.212-216
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    • 2011
  • Purpose: Ameloblastomas are rare benign tumors of odontogenic origin, and compose about 1% of all oral and maxillomandibular cysts and tumors. Because this neoplasm has a high rate of local recurrence, segmental mandibulectomy with a 1~2 cm safety margin and immediate microsurgical reconstruction is an accepted treatment modality. The authors experienced four mandibular reconstruction cases that underwent secondary dental implantation. Here, the authors describe these cases and their long-term results. Methods: Four patients with ameloblastoma of the mandible underwent segmental mandibulectomy and reconstruction with a free fibula osseous flap from January 1999 to May 2005, followed by secondary dental implantation. Recurrence, bony union, implant osseointegration, and functional and aesthetic results were evaluated by radiologic imaging, by physical examination, and by using photographs. Results: All free flaps survived with no evidence of flap loss. To date, no recurrence has been noted clinically or radiologically. Imaging after mandibular reconstruction with a free fibular flap revealed satisfactory bony unions and mandibular contours. The patients achieved good aesthetic and functional results after the secondary implantation. Conclusion: Mandibular reconstruction using a fibular osseous flap and secondary dental implantation can produce good functional and aesthetic results after segmental mandibulectomy for ameloblastoma.

Kirschner 철사와 원형 철사를 이용하여 개의 휘어진 경골 골절을 정복한 증례 (Reduction of Bowed Tibia Fracture by Fixation with Kirschner and Cerclage Wires in a Dog: A Case Report)

  • 엄미영;김영기;왕지환;이희천;이효종;연성찬
    • 한국임상수의학회지
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    • 제25권5호
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    • pp.408-410
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    • 2008
  • A four months old, 3.6 kg intact female Miniature Dachshund dog was referred for non-weight bearing lameness at right hind limb due to car accident. On physical examination, the patient was non-weight bearing on the right hind leg and had moderate swelling in the proximal to middle tibia region. There was palpable crepitus. Radiographs revealed a slightly displaced, spiral, oblique fracture involving the proximal diaphyseal region of the right tibia. Fibular fracture was also noted. Internal fixation was performed to repair the fracture. Due to bowed shape of fractured tibia, it was not possible to apply K-wire, containing appropriate diameter ($60{\sim}80%$ of bone marrow diameter) for intramedullary fixation. We fixed the bowed tibia fracture using a smaller diameter (30% of bone marrow diameter) K-wire with cross pins and cerclage wires. Four weeks after the operation, radiographs demonstrated healing of the tibia fracture as well as the fibular fracture.

움직임을 동반한 발목 가동 테이핑에 비골 재위치 테이핑의 추가가 발목 배측굴곡 제한을 가진 만성 뇌졸중 환자의 발목 관절가동범위, 균형 및 보행에 미치는 영향 (Effects of the Addition of Fibular Repositioning Taping to the Ankle Mobilization with Movement Taping on the Ankle Range of Motion, Balance, and Gait Performance in Patients with Chronic Stroke with Limited Ankle Dorsiflexion)

  • 양성화;이호종;신영일
    • 대한정형도수물리치료학회지
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    • 제28권2호
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    • pp.57-65
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    • 2022
  • Background: This study examined the effects of adding fibular repositioning taping (FRT) to ankle mobilization with movement taping (AMT) on the ankle range of motion (ROM), balance, and gait performance in patients with chronic stroke with limited ankle dorsiflexion. Methods: The participants were randomized into the control (n=15) and AMT+FRT groups (n=15). The control groups applied only non-elastic taping on the affected ankle, and the AMT+FRT groups also applied non-elastic taping to the inferior tibiofibular joint. Both groups performed treadmill walking for 10 minutes. The ankle dorsiflexion passive ROM, balance, gait velocity, and cadence were measured before and after the intervention. Results: Both groups showed a significant difference after the intervention in the dorsiflexion ROM (p<.01), balance (p<.01), and gait performance (p<.01). On the other hand, no significant difference was observed between the two groups (p>.05). Conclusion: AMT improved ankle dorsiflexion passive ROM, balance, gait velocity, and cadence in patients with chronic stroke, but there was no difference between the two groups. Therefore, the addition of FRT to AMT does not influence the ankle dorsiflexion ROM, balance, and gait performance in patients with chronic stroke.

발목 골절 환자에서 삼각인대봉합술이 원위경비인대결합에 미치는 영향 (Effect of Deltoid Ligament Repair on Syndesmotic Stabilization in Patients with Ankle Fractures)

  • 김대욱;최홍준
    • 대한족부족관절학회지
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    • 제27권2호
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    • pp.58-66
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    • 2023
  • Purpose: This study aimed to evaluate the effectiveness of deltoid ligament repair on syndesmotic stabilization in patients with acute ankle fractures with ruptured deltoid and syndesmotic ligaments. Materials and Methods: The medical records of 41 patients (41 ankles) who underwent surgery for Weber type B ankle fracture with ruptured deltoid and syndesmotic ligaments were retrospectively analyzed. The mean follow-up duration was 36 months (range 18~65 months). Patients were divided into two groups: those that underwent deltoid ligament repair (the deltoid group) and those who did not (the non-deltoid group). Both groups were also divided into two subgroups, namely, the D1/S1 group, which underwent syndesmotic screw fixation, or the D2/S2 group, which did not. Medial clear space (MCS), tibiofibular clear space (TFCS), anterior fibular line (AFL) ratio, and posterior fibular line (PFL) distance were measured, and visual analog scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS), and Foot Function Index (FFI) scores were evaluated. Results: TFCS changed significantly after surgery in the D2 and S1 groups (p=0.01, p=0.03, respectively). Subgroup MCSs, TFCSs, and AFL ratios were not significantly altered by surgery in the four subgroups (p=0.82, p=0.45, p=0.25, respectively). However, postoperative PFL distances were significantly different in the D2 and S1 groups and the S1 and S2 groups (p=0.02, p=0.02, respectively). Mean TFCS decreased significantly after surgery in the D2 and S1 groups. The postoperative VAS, AOFAS scores, and FFI were not significantly different between the subgroups (p=0.44, p=0.40, and p=0.46, respectively). Conclusion: Deltoid ligament repair seemed to restore ankle stability without addressing syndesmosis in Weber type B ankle fractures with rupture of deltoid and syndesmotic ligaments.

심한 내반 변형의 진행성 관절염 환자의 인공 슬관절 전치환술 시 경골 근위부의 내반을 동반한 외회전 변형 (External Tibial Torsion with Proximal Tibia Vara in Total Knee Arthroplasty of Advanced Osteoarthritis with Severe Varus Deformed Knees)

  • 선두훈;송인수;김준범;김철우;정덕희;정의탁
    • 대한정형외과학회지
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    • 제55권1호
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    • pp.62-70
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    • 2020
  • 목적: 경골-대퇴 각이 20° 이상인 심한 내반 변형의 진행성 관절염 환자에서 경골 근위부의 내반과 외회전 변형이 보고된 바 있다. 저자들은 인공 슬관절 전치환술 시 경골 근위부의 외회전 변형 및 골간단 상부의 내반 변형에 대하여 방사선적 계측으로 대조군과 비교하였고 수술 전후의 방사선 및 임상 결과를 알아보았다. 대상 및 방법: 2007년 1월부터 2016년 3월까지 인공 슬관절 전치환술 중 수술 전 기립 방사선상 경골-대퇴 각이 20° 이상의 내반 변형을 보이고 2년 이상 추시가 가능했던 37명, 43 슬관절을 대상으로 하였다. 평균 추시 기간은 45.7개월이었다. 비수술적 치료를 받은 Kellgren-Lawrence 제3단계이며 경골-대퇴 각이 3° 이하인 43 슬관절을 대조군으로 설정하여 경골 근위부의 외회전 변형과 내반 변형을 비교하였다. 경골 근위부의 외회전 변형은 단순 방사선상의 근위 경비골 중첩 길이와 컴퓨터 단층촬영 상의 경골 염전각을, 근위 경골의 내반 변형은 근위 경골 경사각을 대상군과 대조군에서 각각 측정하여 비교하였다. 대상군의 수술 전후에 근위 경비골 중첩 길이, 경골 염전각, 근위 경골 경사각, hospital for special surgery (HSS) 점수를 측정하여 비교하였다. 결과: 대상군의 수술 전 및 추시상 근위 경비골 중첩길이는 각각 평균 18.6 mm, 평균 11.2 mm (p=0.031)로, 대조군의 평균 8.7 mm와 통계적으로 유의한 차이가 있었다(p=0.024). 경골 염전각은 수술 전 평균 13.8°에서 최종 추시 상 평균 14.0°로 통계적 유의성이 없었으며(p=0.489), 대조군의 평균 21.9°와 통계적으로 유의한 차이가 있었다(p=0.012). 근위 경골 경사각은 수술 전 평균 12.2°, 최종 추시상 평균 0°였으며(p<0.01), 대조군의 평균 1.2°와 통계적으로 유의한 차이가 있었다(p<0.01). 대상군의 임상적 결과는 HSS 점수가 수술 전 평균 34점에서 최종 추시 시 평균 87점으로 증가하였으며 통계적으로 유의성이 있었다(p=0.028). 결론: 20° 이상의 심한 내반 변형의 진행성 관절염 환자는 대조군에 비해 근위 경골의 외회전 변형과 골간단 상부의 내반 변형이 통계적으로 의미 있게 증가되었다. 대상군의 수술 전후의 경골 염전각은 통계적으로 의미 있는 변화가 없었으나 합병증 없이 좋은 임상 결과를 보였다.