• 대한골관절종양학회지
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• 제9권1호
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• pp.38-44
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• 2003

목적: 장관골 단순성 골낭종에 동반된 병적 골절의 치료 결과를 분석하여 적절한 치료방법을 제시하고자 한다. 대상 및 방법: 1993년 12월부터 2001년 5월까지 장관골 단순성 골낭종에서 병적 골절을 동반한 12예를 대상으로 하였다. 연령분포는 2세에서 19세까지 평균연령 9세였고, 남자 11명, 여자 1명이었으며 추시 기간은 12개월에서 69개월까지 평균 32.9개월이었다. 병적 골절에 대하여 일차적으로 보존적 치료를 원칙적으로 하였으며, 전위가 있는 체중 부하부위 골절은 수술적 치료를 시행하였다. 골절 유합 후 남은 잔존 병소에 대하여 국소적 스테로이드 주입법, 피질천공술 또는 소파술 및 골이식술을 시행하였으며 골유합 소견이 보이면서 골낭종의 치유소견이 관찰되는 경우에는 특별한 처치 없이 관찰하였다. 추시 기간 중 효과 판정 방법은 낭종이 완전히 치유된 경우를 우수(excellent), 낭종이 치유 되가는 과정을 보인 경우 양호(good)로 판정하였으며, 낭종의 크기의 변화가 없거나 계속 커지는 경우를 불량(poor)으로 판정하였다. 결과: 병적 골절은 보존적 치료(9예)와 관혈적 정복술(3예)을 통하여 전례에서 유합 소견을 보였다. 골유합 후 골낭종의 치유소견이 보여 특별한 처치 없이 관찰한 6예에서 양호이상의 결과를 얻을 수 있었다. 잔존병소가 지속되는 6예에 대해서는 국소적 스테로이드 주입법(3예), 피질 천공술(1예) 또는 소파술 및 골이식술(2예)을 시행 후 양호이상의 결과를 얻었다. 결론: 단순성 골낭종에 동반된 장관골 병적 골절의 치료에서 전위가 없거나 도수 정복이 가능한 경우 보존적 치료가, 체중 부하부위의 전위골절의 경우 관혈적 정복술이 좋은 치료법으로 사료된다. 또 병적 골절의 골유합 소견을 얻은 후 골낭종의 치유소견이 나타나는 경우 지속적 관찰이 필요하며, 잔존 병소가 지속되는 경우 이차적 치료를 고려하여야 할 것으로 사료된다.

• Journal of Yeungnam Medical Science
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• 제2권1호
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• pp.11-22
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• 1985

본 영남의대 정형외과학 교실에서는 1983년 5월부터 1985년 2월말까지 치료한 노년층의 대퇴경부 골절 환자 30예 중 추시가 가능했던 18예를 골절의 양상 및 치료 방법에 따라 분석한 결과를 요약하면 다음과 같다. 1. 총 18예 중 여자가 11예, 남자 7예로 고령의 여자에 호발하였다. 2. 60대 이상의 골절 11예 중 8 예가 경도의 외상에 의하였고 4 예가 심각한 골조송증을 동반하였다. 3. 골절의 양상으로는 총 18예 중 4 예가 비전위 골절, 11예가 전위된 골두하 골절, 3 예가 전위된 중간경부 골절이었다. 특히 60대 이상의 골절 11예는 3예가 비전위 골절, 나머지 8 예가 전위된 골두하 골절이었다. 4. 치료 방법은 총 18예 중 13예에서 도수정복 및 다발성 철침 고정술을 시행하였고, 4예에서 대퇴골두 치환술을 1예에서 특별한 처치를 하지 않았다. 5. 내고정술을 시행한 비전위 골절 4예에서는 합병증을 초래하지 않았고, 전위된 골절 9예 중 4예에서 합병증을 초래하였는데 전 예가 전위된 골두하 골절이었다. 6. 전위된 골두하 골절로 내고정술을 시행한 6 예중 3예에서 3일이내에 치료하였는데 이 중 l 예에서 과내반 정복 상태로 합병증을 초래하였고 3일 이상 지연된 3예에는 전 예에서 합병증을 초래 하였다. 7. 전위된 골두하 골절 6예 중 과외반 정복된 2예에서는 합병증이 발생하지 않았고 과내반 정복된 3예와 수상후 1주일 이후에 양호한 정복 상태인 1예 모두 합병증이 발생하였다. 노년기의 대퇴경부 골절 환자의 치료시에 합병증의 발생은 대개 골절의 양상 및 치료 시기에 의해 결정되며, 내고정술시에는 조속한 시간내에 해부학적 정복 혹은 외반 정복을 시도하는 것이 바람직하며 특히 고령의 환자에서 전위된 골두하 골절로 치료의 지연, 정복의 불가능, 과내반 정복 및 고관절에 기존 질병이 있는 경우에는 일차적인 대퇴골두 치환술 혹은 고관절 치환술이 바림직할 것으로 사료된다.

• 한국응급구조학회지
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• 제3권1호
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• pp.102-115
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• 1999

This study was performed to investigate transport activities and strategize improvement of 119 rescue. We reviewed emergency care records of users who were transported by 119 rescue of six agencies in Chungnam from July 13, 1998 to August 8, 1998. The results were as follows ; 1. In sex distribution of users, the male was 65.0%. And the highest age group among users was above sixties(21.6%), then thirties in second order(19.3%). Accident was 50.8% as occupied first cause of transport, and then acute disease 22.8%. The highest requester for 119 rescue call was patient's families(47.1%) and average number of 119 rescue users per day was 20.9. 2. The nonurgent state of users was 58.9%. The frequency of users was 26.0 persons at sunday in most frequently, weekend and holiday was more common than ordinary day, and most frequent weather state was cloudy(23.8 persons). 3. Total running distance of 119 ambulance was 7.0km in average. Call time by users was 20-24 hours most commonly(21.9%). In then running time by each transport stage, 8 minutes were taken from 119 call receipt to scene arrival, 13 minutes from scene arrival to hospital. The kinds of pre-hospital care by 119 rescuer was vital sign check(81.2%), wound dressing or fracture fixation(41.2%), airway maintenance and O2 supply(30.4%).

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권5호
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• pp.207-213
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• 2014

Fractures of the mandible occur with a greater frequency in the elderly. This study reports three cases of edentulous atrophic mandible fracture in elderly patients treated with open reduction technique. Three patients who presented with edentulous atrophic mandible fractures underwent surgical management using open reduction and internal fixation. After treatment, clinical evaluations and postoperative complications were examined with postoperative x-ray. Patients were followed with clinical and radiographic examinations. In the postoperative clinical evaluation, two male patients healed well, but one female patient complained of pain and swelling. In radiographic examinations, no union delay or lack of fusion was observed in the edentulous area. Open reduction technique is a viable treatment option for the edentulous atrophic mandible fractures in geriatric patients.

• Archives of Reconstructive Microsurgery
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• 제24권2호
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• pp.41-49
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• 2015

Free or pedicled vascularized fibular grafts (VFG) are useful for the reconstruction of large skeletal defects, particularly in cases of scarred or avascular beds, or in patients with combined bone and soft tissue defects. Compared to non-VFG, VEG, which contains living osteocytes and osteoblasts, maintains its own viability and serves as good osteoconductive and osteoinductive graft. Due to its many structural and biological advantages, the free fibular osteo- or osteocutaneous graft is considered the most suitable autograft for the reconstruction of long bone defects in the injured extremity. The traditional indication of VFG is the long bone and soft tissue defect, which cannot be reconstructed using a conventional operative method. Recently, the indications have been widely expanded not only for defects of midtibia, humerus, forearm, distal femur, and proximal tibia, but also for the arthrodesis of shoulder and knee joints. Because of its potential to allow further bone growth, free fibular epiphyseal transfer can be used for the hip or for distal radius defects caused by the radical resection of a tumor. The basic anatomy and surgical techniques for harvesting the VFG are well known; however, the condition of the recipient site is different in each case. Therefore, careful preoperative surgical planning should be customized in every patient. In this review, recently expanded surgical indications of VFG and surgical tips based on the author's experiences in the issues of fixation method, one or two staged reconstruction, size mismatching, overcoming the stress fracture, and arthrodesis of shoulder and knee joint using VFG are discussed with the review of literature.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권1호
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• pp.49-55
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• 2004

The management of mandibular condylar fractures in children has long been a matter of controversy. The fracture, if not treated appropriately, may result in complications such as disturbance of mandibular growth and temporomandibular joint ankylosis. They are usually treated nonsurgically, which has been proved to be satisfactory in the long term results. Nineteen children with 25 condylar fractures experienced during their growth period (age at trauma from 10 months to 12 years, mean 7.0 years) were studied. All patients were treated by arch bars and intermaxillary fixation for $7{\sim}14$ days. They have been evaluated with clinical and radiographic examination. The maximum mouth opening and lateral movement of the mandible were within normal limits. There was no malocclusion or ankylosis. Beginning of remodelling was evident at postoperative $1{\sim}3$ months. Remodelling of the condyle was good in 21, while partial adjustment occured in the other 4 condyles. These results suggest that the conservative treatment of condylar fractures in growing children results in good functional results and good remodelling of the condyle.

• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권2호
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• pp.174-181
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• 2007

Today, endoscopic procedures are common in diagnostic and other surgical procedures, with endoscopically enhanced and magnified images permitting surgical access through minimal incisions. This has expanded the treatment options for many difficult anatomic sites, and the endoscope facilitated safe anatomic reduction and fixation. The use of the endoscope may reduce the disadvantages of open fracture repair and should be considered for broad application in the treatment of displaced facial bone fractures. Optical endoscopic magnification minimizes the disadvantages associated with open surgical repair, including the risk of facial nerve injury and external facial scarring, and no postoperative complications have been attributable to the endoscopic approach. This technique was used in 14 patients treated at Ulsan University Hospital, Korea, from September 2004 to August 2006, including six mandibular subcondyle fractures, five blowout fractures and three zygomaticomaxillary complex (ZMC) fractures. Careful preoperative evaluation and proper surgical technique were essential to achieve optimal results in the selected patients.

• Journal of Korean Neurosurgical Society
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• 제29권2호
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• pp.255-260
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• 2000

The authors report a posttraumatic syringomyelia in a 30-year-old man who has complained pain, weakness of upper arm and dissociation sensory loss since 2 months before. He was underwent by decompressive laminectomy from T12 to L1, reduction of encroached bony fragments, transpedicular screw fixation from T12 to L2 and posterolateral bony fusion due to burst fracture of L1 at other hospital 3 years ago. Preoperative spinal MRI was highly suggestive of wide-spread, multiseptated syringomyelia from C3 to thoracolumbar junction. We performed wide decompressive laminectomy from T10 to L2 and subarachnoid space reconstrucion composed of microdissection of meningeal fibrosis widely, iatrogenic meningocele formation with lefting the dura mater opened for treatment of spinal-spinal pressure dissociation. Clinical manifestations and radiological findings of the patient were improved after the operation. This technique was thought to be superior to shunting procedures in cases of wide-spread, multiseptated post-traumatic syringomyelia.

• Journal of Korean Neurosurgical Society
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• 제57권1호
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• pp.61-64
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• 2015

A number of dynamic stabilization systems have been used to overcome the problems associated with spinal fusion with rigid fixation recently and the demand for an ideal dynamic stabilization system is greater for younger patients with multisegment disc degeneration. Nitinol, a shape memory alloy of nickel and titanium, is flexible at low temperatures and regains its original shape when heated, and the Nitinol shape memory loop (SML) implant has been used as a posterior tension band mostly in decompressive laminectomy cases because the Nitinol implant has various characteristics such as high elasticity and a tensile force, flexibility, and biological compatibility. The reported short-term outcomes of the application of SMLs as posterior column supporters in cervical and lumbar decompressive laminectomies seem to be positive, and complications are minimal except for the rare occurrence of pullout and fracture of the SML. However, there was no report of neurological complications related to neural compression in spite of the use of the loop of SML in the epidural space. The authors report a case of delayed development of radiating pain caused by subsidence of the SML resulting epidural compression.