• The Korean Journal of Pain
• /
• 제24권4호
• /
• pp.239-241
• /
• 2011

• Journal of Yeungnam Medical Science
• /
• 제5권1호
• /
• pp.43-48
• /
• 1988

골절의 모양, 범위 및 골편의 해리의 정도를 C.T.로서 잘 결정할 수 있었다. 고관절을 비롯한 기타 골반골의 골절과 연부 조직손상 정도를 잘 알 수 있었다. 고식적인 단순 Z-선 촬영으로 발견이 안 되었던 고관절내 골편의 유 무를 잘 관찰할 수 있었다. 골반골 골절이 있는 움직이기 어려운 환자에서 검사가 쉽고, 용이하게 이루어질 수 있었다. 수술후 관절강내 골편이나 개방성복술에 대한 평가를 잘 할 수 있었다.

• 대한관절경학회지
• /
• 제16권2호
• /
• pp.180-184
• /
• 2012

진균에 의한 감염성 관절염은 면역 억제 치료자, 약물 남용자, 장기간의 항생제 투여자 등에서 발생하는 드문 질환으로 특히 건강한 성인에서의 감염은 매우 드물다. 진균에 의한 슬관절의 감염성 관절염은 국내에서 2예의 보고가 있으나, 건강한 성인에서 발생한 진균성 슬관절염은 아직 보고된 바가 없는 실정이다. 이에 저자들은 건강한 성인에서 반복적인 관절 내 스테로이드 주사 후 발생한 진균성 관절염 및 이와 동반한 슬와낭종의 관절경적 치료를 경험하여 문헌 고찰과 함께 보고하는 바이다. 진균성 슬관절염은 특징적인 임상상이 없는 드문 질환으로, 진단에 있어 어려움이 있으므로 면밀한 관찰과 주의를 요한다.

• 대한족부족관절학회지
• /
• 제7권1호
• /
• pp.68-77
• /
• 2003

Purpose: The treatment of calcaneal fractures remains a controversy in orthopaedic field because of its complications. The purpose of this study is to evaluate the efficacy of the treatment of calcaneal fractures and its complications. Materials and Methods: Clinical and radiological results were retrospectively analyzed in 28 patients, 34 cases with fractures of calcaneus which were treated in our department from September 1998 to march 2003. Results: According to the Creighton-Nebraska Foundation Assessment score, there were 3 excellent, 11 good, and 12 fair 6 poor results. Bohler angle was corrected from $8.3^{\circ}$ to $18.3^{\circ}$, Gissane angle was corrected from $121^{\circ}$ to $135^{\circ}$, and calcaneal width was corrected from 46.8mm to 37mm. Conclusion: Open reduction and internal fixation for joint depression type calcaneal fractures thought to be a good method of treatment. Closed reduction and percutaneous axial pinning should be chosed in selected cases of tongue type fractures. In treatment of complicated calcaneal fractures as malunion, subtalar distraction arthrodesis and lateral wall exostectomy will reduce disability of the disease.

• The Korean Journal of Pain
• /
• 제31권4호
• /
• pp.289-295
• /
• 2018

Background: The intraarticular (IA) injection has become popular for the management of the osteoarthritic knee without an effusion. The success rate of IA injection would be better if it was able to be visually confirmed. We hypothesized that an anterolateral approach, which targets the synovial membrane of the lateral condyle using ultrasound, would provide an equivalent alternative to the anterolateral approach, targeting the synovial membrane of the medial condyle for IA injection of the knee. Methods: A total of 96 knees with osteoarthritis were randomized placed into the two groups, which were group I (anterolateral approach to the medial condyle) and group II (anterolateral approach to the lateral condyle). The primary outcome was to compare the success rate of the two methods of IA injection. The required length of the needle for injection was also measured and compared. Pain intensity was assessed using the Numeric Rating Scale in order to evaluate the success of injection. Results: There were no significant differences in the success rate between both groups. The success rate of group I and group II were 87.8% (95%, CI 78.7-97.0) and 91.5% (95%, CI 83.6-99.5), respectively (P = 0.549). The needle depth was $5.0{\pm}0.8$ (3.0 to 6.1 cm) in group I, and $3.0{\pm}0.8$ (1.5 to 5 cm) in group II (P < 0.001). Conclusions: The anterolateral approach to the lateral femoral condyle, using ultrasound, is an alternative method to the approach targeting the medial femoral condyle, using shorter needle.

• 대한족부족관절학회지
• /
• 제15권2호
• /
• pp.51-57
• /
• 2011

Pilon fractures involving distal tibia remain one of the most difficult therapeutic challenges that confront the orthopedic surgeons because of associated soft tissue injury is common. To introduce and describe the diagnosis, current treatment, results and complications of the pilon fractures. In initial assessment, the correct evaluation of the fracture type through radiographic checkup and examination of the soft tissue envelope is needed to decide appropriate treatment planning of pilon fractures. Even though Ruedi and Allgower reported 74% good and excellent results with primary open reduction and internal fixation, recently the second staged treatment of pilon fractures is preferred to orthopedic traumatologist because of the soft tissue problem is common after primary open reduction and internal fixation. The components of the first stage are focused primarily on stabilization of the soft tissue envelope. If fibula is fractured, fibular open reduction and internal fixation is integral part of initial management for reducing the majority of tibial deformities. Ankle-spanning temporary external fixator is used to restore limb alignment and displaced intraarticular fragments through ligamentotaxis and distraction. And the second stage, definitive open reduction and internal fixation of the tibial component, is undertaken when the soft tissue injury has resolved and no infection sign is seen on pin site of external fixator. The goals of definitive internal fixation should include absolute stability and interfragmentary compression of reduced articular segments, stable fixation of the articular segment to the tibial diaphysis, and restoration of coronal, transverse, and sagittal plane alignments. The location, rigidity, and kinds of the implants are based on each individual fractures. The conventional plate fixation has more advantages in anatomical reduction of intraarticular fractures than locking compression plate. But it has more complications as infection, delayed union and nonunion. The locking compression plate fixation provides greater stability and lesser wound problem than conventional implants. But the locking compression plate remains poorly defined for intraarticular fractures of the distal tibia. Active, active assisted, passive range of motion of the ankle is recommended when postoperative rehabilitation is started. Splinting with the foot in neutral is continued until suture is removed at the 2~3 weeks and weight bearing is delayed for approximately 12 weeks. The recognition of the soft tissue injury has evolved as a critical component of the management of pilon fractures. At this point, the second staged treatment of pilon fractures is good treatment option because of it is designed to promote recovery of the soft tissue envelope in first stage operation and get a good result in definitive reduction and stabilization of the articular surface and axial alignment in second stage operation.

• 대한자기공명의과학회:학술대회논문집
• /
• 대한자기공명의과학회 2007년도 학술대회
• /
• pp.52-53
• /
• 2007

• Clinics in Shoulder and Elbow
• /
• 제6권2호
• /
• pp.138-142
• /
• 2003

The Bennett lesion is an extraarticular ossification of the posteroinferior quadrant of the glenoid. The lesion may be a source of shoulder pain in throwing athletes. The Bennett lesion may be caused by traction on the posterior band of the inferior glenohumeral ligamentous complex produced by posteroior subluxation during cocking, posterior subluxation during cocking, posterior decelerate forces during follow-through, or a combination of the two. Treatment is usually conservative and focused at the associated intraarticular abnormality and pathomechanics.

• 대한족부족관절학회지
• /
• 제11권2호
• /
• pp.226-231
• /
• 2007

Purpose: To evaluate the clinical outcomes and radiographic results of open reduction and internal fixation for intraarticular calcaneal fractures. Materials and Methods: We reviewed 20 cases of calcaneal fractures managed with open reduction and internal fixation from March 2003 to January 2005. We used the computed tomographic classification system proposed by Sanders et al to classify these fractures. Preoperative and postoperative Bohler's angle, heel height (calcaneal facet height) and calcaneal length, calcaneal width were measured. The Creighton-Nebraska Health Foundation Assessment score was used for clinical evaluation. Results: There were 12 cases of type II fractures, 5 of type III fractures and 3 of type IV fractures. The mean clinical score was 84.3 for type II, 82.6 for type III and 56.1 for type IV. The mean preoperative $B{\ddot{o}}hler$ angle was $6.1^{\circ}$ and final was $22.8^{\circ}$. The mean preoperative calcaneal facet height was 76.6 mm and final was 80.3 mm (The mean calcaneal facet height was changed from preop 76.6 mm to postop 80.3 mm). The mean preoperative calcaneal length was 88.2 mm and final was 92.6 mm. The mean preoperative width was 38.1 mm and final was 35.6 mm. Conclusion: Open reduction and internal fixation showed good results for type II and III fractures, but for type IV fractures the clinical result was significantly worse than the other types. However, type IV fractures still had restoration of (should be restored in) $B{\ddot{o}}hler's$ angle, calcaneal facet height, calcaneal length and width which may be helpful in later subtalar fusion.

• 대한족부족관절학회지
• /
• 제11권1호
• /
• pp.67-71
• /
• 2007

Purpose: To evaluate clinical results of the 5th proximal metatarsal intraarticular fracture (Zone I) with displacement treated operatively and to evaluate predisposing factors of the 5th proximal metatarsal fracture (Zone I). Materials and Methods: 11 patients treated for the 5th proximal metatarsal fracture (Zone I) operatively and 10 patients treated conservatively between Jan 2003 and Dec 2005, were followed for more than one year. Functions were graded by AOFAS foot scoring system and union time and postoperative complications were also evaluated. Calcaneal pitch angle was also evaluated. Results: Clinically there were no much difference in results. Clinical points were 94.5 in the operative group and 92.3 in the conservative group. At the last follow-up, the radiographic results showed union in all cases. During the follow-up period, there were no significant complications. But in the conservative group, displaced fracture with calcaneal pitch angle over 30 degree tends to show delayed union and time to loss of pain tends to be prolonged. Conclusion: Calcaneal pitch angle is thought to predisposing factor for 5th metatarsal base fracture. Operative treatment is viable option for the 5th proximal metatarsal intraarticular fracture with displacement and with calcaneal pitch angle over 30 degree. In cases of cavovarus foot deformity, we think operative treatment should be considered with deliberation and long term follow-up study for peroneal tendinopathy should be needed.