• Clinics in Shoulder and Elbow
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• 제13권2호
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• pp.266-269
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• 2010

목적: 3년이 경과된 진구성 주관절 탈구 증례를 경험하였기에 보고하고자 한다. 대상 및 방법: 45세 여자가 3년이 경과된 진구성 주관절 탈구로 수술적 소견상 주관절 외측 및 내측 측부 인대는 구축되어 있어 박리술을 시행하였다. 후방 관절낭을 완전히 유리시키고 전방 관절낭을 절개한 이후 수동적 조작을 가하여 요상완 및 척상완 관절을 정복시켰다. 변형된 Morrey형의 경첩형 외고정 장치를 주관절부에 장착하고 조기 주관절 운동을 시행하였다. 결과 및 결론: 저자들은 3년이 경과된 진구성 주관절 탈구에서 개방적 정복과 경첩형 외고정 장치를 이용한 고정술의 만족스런 결과를 경험하여 문헌고찰과 함께 보고하는 바이다.

• 대한족부족관절학회지
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• 제14권2호
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• pp.146-150
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• 2010

Purpose: Pilon fracture has several serious complications such as joint stiffness, arthrosis and delayed angular deformity. We report short-term results of new treatment modality using distracted dynamic external fixators and early controlled ankle motion. Materials and Methods: Eight cases of severe pilon fractures for which we tried small plate fixation and additional distracted dynamic external fixators from July 2007 to June 2009 were included. Half passive continuous ankle joint motion was allowed under free hinged ring fixators after the operation. The external fixators were removed after two or three months from the surgery. We investigated joint space by radiograph, joint pain, range of motion, patient's satisfaction of treatment protocol. Results: Joints were distracted when external fixators were applied and mean 28% of space loss developed after removal of external fixators. In most of cases, satisfactory alignments were maintained. Regarding range of joint motion, mean dorsiflexion angle was 15 degrees and mean plantarflexion angle was 32 degree in the condition of wearing external fixators. There was mean 8% reduction of range of motion but no further progression of ankle stiffness after removal of external fixators. Dorsiflexion was not improved after that, but plantarflexion angle was improved 10% even after removal of external fixators. Patients were generally in compliance with the treatment protocols with high level of satisfaction. Conclusion: We got good results with distracted dynamic external fixators and early continuous half-passive joint motion for pilon fractures in terms of joint pain and range of motion. Therefore we suggest this new protocol as an alternative modality for severe pilon fractures.