• Journal of Animal Science and Technology
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• 제51권2호
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• pp.97-104
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• 2009

교류와 경쟁력 향상을 위해서는 검정기준, 평가방법과 모델 등에 많은 보완이 필요하다. 따라서, 본 연구는 현재 국내의 50단계의 심사점수를 낙농선진국에서 채택하고 있는 9점제로의 변환을 통해 국제기준을 국내 현실에 맞게 적용하기 위해 실시했다. 분석에는 한국 종축개량협회(KAIA)의 젖소에 대한 혈통기록 및 2001에서 2006년도 사이에 실시된 체형 측정 기록 중 최종점수와 15개 체형형질에 대해 초산차의 기록을 갖는 32,487두의 암소집단의 선형심사기록 자료가 이용되었다. 9점제로 변경한 집단이 더욱 정규성을 띄는 분포 특성을 나타내었다. 상관분석결과에서도 모든 형질에서 50점제와 9점제 심사 점수간에 0.98 이상의 상관계수를 나타내었다. 따라서, 50 점제에서 9점제로의 변경이 가능할 것으로 판단된다. 하지만, 9점제로의 변환 후 모든 형질에서 심사자에 따라 고도의 유의성을 보였고(P<0.001), 점수제간 F값은 발굽기울기와 앞유방의 붙음성은 심사자간 변이가 비교적 높게 나타났다. 이것은 9점제로의 변환 후에도 심사자의 주관적인 요소가 점수에 영향을 미치는 것을 의미한다. 따라서, 선형형질 점수제 변환은 환경효과에 대한 다양한 분석을 통하여 적합성 여부를 결정해야 할 것이다.

• 대한족부족관절학회지
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• 제22권3호
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• pp.95-99
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• 2018

Purpose: The purpose of this study was to evaluate the radiologic outcomes of distal fibular fractures and to analyze the risk factors associated with nonunion. Materials and Methods: Between January 2009 and March 2016, 13 patients who had final nonunion with ankle fracture were included. In the control group, 370 patients who had undergone bony union and removed metal implants were included. All patients underwent the same surgical procedure and had the same treatment method, ultimately achieving satisfactory open reduction results with less than 2 mm fracture gap. Surgical treatment of fracture was considered to have the same effect on nonunion, and factors that might be associated with nonunion were evaluated. SPSS ver. 13.0 (SPSS Inc., USA) was used for all statistical analyses. Pearson's chi-square test and multi-variate regression analysis were performed to determine the factors affecting nonunion of distal fibular fracture. A p-value less than 0.05 was considered statistically significant, and relative risk was assessed. Results: The mean age of 13 patients was 46.9 years (range, 16~57 years); there were 8 men and 5 women. Among the 13 patients with nonunion, atrophic was the most common (12 cases). The association between the injury mechanism and the Lauge-Hansen classification and diabetes mellitus was not statistically significant. Distal fibular fractures with tibia shaft fracture (p=0.015) and Danis-Weber type C fracture (p=0.023), open fracture (p=0.011), and smoking (p=0.023) were significantly associated with nonunion. Conclusion: In this study, the combined injury of the ipsilateral tibia shaft fracture, open fracture, and Danis-Weber type C fracture may increase the possibility of nonunion. Therefore, caution is advised to prevent nonunion.

• 대한족부족관절학회지
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• 제5권2호
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• pp.112-119
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• 2001

Purpose: The purpose of this study is to analyze the clinical prognostic factors which may affect the postoperative clinical results of the unstable ankle fractures. Materials and Methods: This study is based on 62 unstable ankle fractures treated by open reduction and internal fixation from May 1994 to June 2000, with a minimum follow-up period of 12 months(range: 13 months-7 years 3 months). The 62 patients were average 39.1 years old with male: female ratio of 41:21. Based on Lauge-Hansen classification, the supination-external rotation type was the most common with 36 (58.1%) cases. The clinical results was assessed by American Orthopaedic Foot and Ankle Society(AOFAS) functional scale. The sex, age, body weight, trauma-operation interval, operation time, cause of injury, fracture type were statistically analyzed as the possible postoperative clinical prognostic factors. Results: Postoperative AOFAS functional scale was average 82.1 points with 22(35.5 %) cases excellent, 12(19.4%) good. 16(25.8%) fair and 12(19.4%) cases poor results. The age and the operation time were found to be statistically significant factors affecting the prognosis(p<0.001). The sex, weight, trauma-operation interval factors did not significantly affect the clinical results. The pronation-external rotation type showed better clinical tendency among the fracture types, but without the statistical significance. Conclusion: The surgically treated unstable ankle fractures in patients whose age was above 41 years old or operation time exceeding 90 minutes showed significantly poor clinical results.

• 대한족부족관절학회지
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• 제16권2호
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• pp.94-100
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• 2012

Purpose: The purpose of this study is to analyze the clinical features of distal tibia fractures and to evaluate the treatment outcomes of minimally invasive plate osteosynthesis (MIPO). Materials and Methods: From January 2004 to December 2009, 84 cases of 81 patients treated with plate fixation for distal tibia fracture were enrolled in this retrospective review. We investigated age, sex, injury mechanism, fracture patterns, and complications, and the clinical features were analyzed. To evaluate the treatment outcomes of MIPO, we divided into two groups. MIPO group consisted of 55 patients were treated with MIPO technique and conventional group consisted of 18 patients were treated with open reduction and internal fixation with conventional anterolateral plating. The results were compared between two groups by assessing bony union time, operation time, amount of blood loss, range of ankle motion, clinical score by American Orthopaedic Foot and Ankle Society (AOFAS) score, and post-operative complications. Results: The mean age of 81 patients with distal tibia fracture was 54.8 years. According to AO classification, A1:2:3 were 16, 20, 16 patients, B1:2:3 were 2, 8, 7, C1:2:3 were 1, 3, 11 patients. According to injury mechanism, slip down injury was patients, traffic accident was 26, fall from height injury was 14 patients respectively. The type A fractures were lower energy trauma and more older patients. The type C fractures were higher energy trauma and younger patients. MIPO group was better than conventional group in operative time, blood loss, bony union time, and ankle joint motion. In complications, MIPO group showed no nonunion and infection, one malunion, one skin necrosis, nine skin irritations, and one screw breakage. Conventional group showed two nonunion, four infections, two skin necrosis, and one metal failure. Conclusion: Distal tibial fractures caused by low energy trauma were on the increase. Minimal invasive plate osteosynthesis was shorter bony union time and operation time, less blood loss, and larger ankle motions than conventional open reduction and plate fixation.

• 대한족부족관절학회지
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• 제11권2호
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• pp.221-225
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• 2007

Purpose: To evaluate the clinical results of operative treatment of the intra-articular calcaneal fracture with injectable calcium sulfate ($MIIG^{TM}$). Materials and Methods: Between March 2004 and October 2006, a total 19 intra-articular calcaneal fracture (16 patients) with a large bony defect that underwent operative treatment with plate fixation and injectable calcium sulfate ($MIIG^{TM}$) with minimum follow-up of one year following. The mean age at time of surgery was 44.7 years (23 to 54). All of the cases were type 2 and 3 on the basis of Sanders classification. The lateral L shaped approach was used in all cases. Full weight bearing on the affected extremity was regained at an average 10 weeks postoperatively. Results: The mean Bohler angle was improved from $2^{\circ}$ ($-18.5{\sim}12.5^{\circ}$) preoperatively to $23.8^{\circ}$ ($12{\sim}37.5^{\circ}$) and the angle at last follow-up was $22.5^{\circ}$ ($11.5{\sim}37.5^{\circ}$), showing about 0.3 degree decline compared to postoperative Bohler angle. Only two case of whitish leakage of graft material but other complication were none. Conclusion: $MIIG^{TM}$ augumentation of displaced intra-articular calcaneal fracture with large bone defect seems to bo useful method for initial stabilized and plate fixation.

• 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.

• 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.

• 대한족부족관절학회지
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• 제17권2호
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• pp.130-135
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• 2013

Purpose: Preshaped Locking compression plate(LCP) has holes with fixed angle between screw and plate and have advantage firm fixation because it has stability of angular and axial deformity. We evaluated usefulness of LCP after open reduction and internal fixation in distal fibular fracture. Materials and Methods: Between December 2011 and May 2012, 23 patients with fracture of distal fibula were followed up at least 12 months underwent open reduction and internal fixation with LCP. There were 15 males and 8 females with a mean age 39.8(20~69) years. According to Danis-Weber classification, there were 20 cases of type B and 3 cases of type C. There were 13 cases of isolated lateral malleolus fractures, 1 case of bimalleolar fracture, 6 cases of trimalleolar fractures and 3 cases of distal tibia fractures with proximal fibula fracture. Intraoperatively, we assessed whether preshaped LCP fit lateral margin of distal fibula or not and evaluated quality of reduction and postoperative complications. The cases were analyzed by radiological bone union time and clinical results according to the criteria of Meyer Results: Of all cases, complete bone union was achieved and average radiological bone union time was 7.3(6~12) weeks. The clinical results were excellent in 18 cases(78%), good in 5 cases(22%). There were 5 cases of plate with 3 holes, 13 cases of plate with 4 holes, 2 cases of plate with 5 holes, 1 case of plate with 6 holes and 2 cases of plate with 7 holes. The average number of screws at proximal fragement was 2.5 and at distal fragment was 3.5. In 14 cases (60.8 %), we needed re-bending of plate because the distance between plate and lateral cortical margin of distal fibula was more than 5 mm at anteroposterior X-ray after reduction. All cases have anatomical reduction and there were no complications of wound infections. There were no complaint about hardware irritation. Conclusion: At fractures of distal fibula,preshaped LCP had a excellent stability although far cortex was not fixed with screw and bending of plate. And there are less complications of hardware irritation and wound problems. But, Some complement would be needed because there were no complete fitting between precontour of LCP and lateral cortical margin of distal fibula.

• 대한정형외과학회지
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• 제55권4호
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• pp.324-330
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• 2020

목적: 족근골 유합의 유병률에 대한 국내의 연구가 드물고 특히 성인에서의 다발성 족근골 유합은 국내뿐만 아니라 외국에서도 유병률에 대한 연구가 부족하기 때문에 본원에 내원한 환자를 대상으로 시행한 영상 검사를 이용하여 한국인의 족근골 유합의 양상 및 유병률에 대해 알아보고자 한다. 대상 및 방법: 2009년 3월부터 2019년 2월까지 본원에서 시행한 족부 및 족관절의 컴퓨터 단층촬영 검사 및 자기공명영상 검사를 시행한 족관절 염좌 및 골절 환자 총 4,711명(남성 4,454명, 여성 257명)을 대상으로 족근골 유합의 유병률 및 양상에 대하여 후향적으로 조사하였다. 결과: 10년동안 총 78명(1.7%)의 환자에서 족근골 유합이 관찰되었고 전체 족근골 유합 환자 중 25명(32.1%)에서 다발성 족근골 유합이 확인되었다. 해부학적 위치에 따라 거골-종골 유합이 단발성(31명 37예, 62.7%) 및 다발성(22명 23예, 45.1%) 족근골 유합 모두에서 가장 흔하게 관찰되었고 단발성 유합에서는 종골-주상골 유합(10명, 16.9%), 주상골-설상골 유합(9명, 15.3%), 입방골-주상골 유합(3명, 5.1%)의 순서로, 다발성 유합에서는 종골-주상골 유합(14명 14예, 27.5%), 거골-주상골 유합(6명 6예, 11.8%)의 빈도 순으로 관찰되었다. 또한 총 60예의 거골-종골 유합 중 후방 관절소면에서 24예(40.0%)의 유합이 확인되었고 중간 관절소면에서 18예(30.0%), 전방 관절소면에서 4예(6.7%)가 관찰되었다. 그리고 조직학적인 분류에 따라 연골성 유합이 단발성(32명 35예, 59.3%) 및 다발성(20명 37예, 72.5%) 4예(6.7%)모두에서 가장 많이 관찰되었다. 결론: 기존의 문헌들을 통해서 알려진 바와 같이 본 연구에서는 거골-종골 유합이 가장 흔하게 나타나는 것으로 확인하였다. 하지만 거골-종골 유합은 대부분 중간 관절소면에서 주로 나타난다고 알려져 있는 것과는 달리 본 연구에서는 후방 관절소면에서 더욱 많이 관찰되었다. 그리고 극히 드물게 관찰되는 것으로 알려진 다발성 족근골 유합은 이제까지 알려진 바와 달리 다양한 양상으로 드물지 않게 발견되는 것을 확인하였다.

• 농촌의학ㆍ지역보건
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• 제21권2호
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• pp.173-193
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• 1996

This study was carried out to elucidate the causes of farmer's disease and greenhouse disease in the rural area of Kyungnam province during 1996. 2,171 (69.1%) of the 3,140 adults above 20 years old who had lived in the selected 20 villages in Uiryong County of Kyungnam Province were selected in order to over both residents who live in the green house distracts and conventional rural area. The results were as follows: 1. Among the subjects, the male was 42.2% and female was 57.6%. The average age for the male was 52.3, 55.6 for the female. 2. The proportion of the farmers in the subjects was 81.5%. Among these 78.0% were engaged in the greenhouse farming. 3. Among the eight symptoms of Nofusho(japanese farmer's comples), lumbago was the most frequently complained and followed by shoulder stiffness and parenthesis of hand or foot. 4. The total score of farmer's disease was evidently higher in the female and the older the score was clearly bigger. 5. The prevalence of Nofusho(Japanese farmer's comples)was 26.8% and 43.15% was for the suspected Nofusho. In the male, the prevalence of Nofusho was 13.6% and 40.9% for the suspected Nofusho and in the female 36.5% and 44.7% were shown, comparatively. 6. According to the multiple classification analysis, sex, age, and occupation were selected as significant variables to explain the total score of Nofusho. 7. The correlations between the total score of Nofusho and the number of sick day, working years, and age were significant, comparatively. 8. According to the multiple classification analysis corolling interaction between independent variables, age was the only variable which was significant in the male and age, pesticide work in the female. 9. The score of greenhouse disease was highest in the group who engaged in greenhouse farming and conventional farming(2.76 for male, 3.77 for female) followed by the group who engaged only in greening house farming(2.66 for male, 3.49 for female) and by the group who engaged only in conventional farming(2.27 for male, 3.05 for female) 10. According to the multiple classification analysis with the total score of greenhouse disease as dependent variable, corolling interaction between independent variables, age and pesticide work were revealed as significant variables in the male, while, pesticide work and farming type were significant in the female. According to the above results, the following could be suggested. Because lumbago, shoulder stiffness, paresthesia of hand and foot were the most frequently complained symptoms in the respondent, the development of farming tool to reduce the body burden and periodical physical exercise and rest is highly recommended. It is revealed that both in the farmer' disease and greenhouse disease the score was higher in the female than in the male. So the reasonables measures is recommended to reduce the working hours of the female. Pesticide work was revealed as the significant variable in the female in farmer's disease and both in the male and the female in greenhouse disease. So the development of the safe method of pesticide spraying including safety education should be introduced. Particularly the female should be excluded in pesticide spraying.