• 대한족부족관절학회지
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• 제16권4호
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• pp.270-275
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• 2012

There may be complications after comminuted or intraarticular calcaneal fracture regardless of the initial treatment. Transcalcaneal talonavicular dislocation is rarely reported severe form of calcaneal fracture. We experienced a neglected transcalcaneal talonavicular subluxation case, who had been treated for intraarticular calcaneal fracture conservatively. Subtalar distraction bone block fusion was done for calcaneal malunion with talonavicular subluxation. Inspite of successful subtalar fusion, pain was persisted because of talonavicular re-subluxation with arthritis and calcaneocuboid arthritis. So, second operation, the talonavicular and calcaneocuboid fusion, was done. After union achieved, the patient's foot pain was improved. Calcaneal malunion combined with talonavicular subluxation and unstable transverse tarsal joint, such as this case, initial triple arthrodesis could be considered.

• 대한골관절종양학회지
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• 제10권2호
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• pp.134-137
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• 2004

골연골종은 가장 흔한 양성골종양으로 대부분 장관골의 골간단에 주로 발생한다. 수부에 발생하는 골연골종은 드물며 그 중 관절내 골연골종은 매우 드문 것으로 되어 있다. 저자들은 53세 여자 환자에서 제 3 중수골 두부에 발생된 관절내 골연종을 보고하고자 한다. 적출된 종물은 $10{\times}8{\times}5$ mm 크기로 명확한 연골모를 가지고 있었다.

• 대한족부족관절학회지
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• 제12권2호
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• pp.174-179
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• 2008

Purpose: We evaluated the clinical results of the intraarticular calcaneal fractures treated using Ollier approach by inexperienced orthopaedic surgeon. Materials and Methods: Between August 2003 and May 2007, Of the total 46 cases, 12 cases (9 patients) of displaced intraarticular calcaneal fracture who underwent open reduction and internal fixation using Ollier approach were evaluated. The means of age was 50.5 years. According to the Sanders classification, there was no type I case and 8 cases of type II, 1 case of type III, and 3 cases of type IV. We evaluated the treatment result by assessing radiologic parameters ($B{\ddot{o}}hler$ angle, Gissane angle, and calcaneal height/width) and clinical outcomes (VAS and AOFAS score). Results: The means of follow-up period was 25.3 months. The means of B.hler angle was improved from $2.4^{\circ}$ to $26.1^{\circ}$. Radiologic and clinical union was achieved in all cases without additional procedures. Excellent result were noted in 2 cases, good in 5 cases, fair in 4 cases, and poor in 1 case. We experienced 2 cases of minor complications; 1 case of mild wound infection and 1 case of hypoesthesia on foot dorsum. Radiologic findings of subtalar arthritis were present in 2 cases. Conclusion: Ollier approach seems to be helpful to inexperienced orthopaedic surgeons for the treatment of intraarticular calcaneal fractures in that it enables them to achieve considerable clinical outcomes without serious complications.

• Journal of Yeungnam Medical Science
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• 제10권2호
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• pp.445-450
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• 1993

전신 흡입 마취로 슬관절경 수술을 받은 건강한 환자 60명을 대상으로 슬관절경내 Morphine 3 mg을 주입한 군(20명)과 0.25% Bupivacaine 20 ml을 주입한 군(20명)과 약제를 주입하지 않은 대조군(20명)의 통증 정도를 술후 1, 2, 4, 6, 12, 24시간 동안 Visual Analogue Pain Scale을 이용하여 비교 평가하여 다음과 같은 결론을 얻었다. 1) 슬관절강내 0.25% Bupivacaine 20 ml을 주입한 군에서 술후 첫 1, 2시간 동안 통계학적으로 의의있는 통증 점수를 나타내었다. 2) 슬관절강내 Morphine 3 mg을 주입한 군에서는 술후 4시간부터 통계학적으로 의의있는 통증 점수가 나타난 뒤 실험이 끝날 때까지 지속적인 진통효과를 나타내었다. 3) 구역, 구토, 소양증, 뇨정체, 호흡억제 등의 전신적인 부작용은 나타나지 않았다. 이상과 같이 소량의 Morphine을 관절강내 주입함으로써 술후 통증을 감소시켜 진통제의 사용량을 줄일 수 있었다.

• 대한족부족관절학회지
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• 제6권2호
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• pp.201-207
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• 2002

Purpose: To present the clinical analysis of the results obtained in 38 cases of displaced intraarticular calcaneal fractures undergone combined percutaneous axial pin fixation of calcaneal body and minimal internal fixation using extensile lateral approach. Materials and Methods: From March 2000 to February 2002, thirty-eight displaced intraarticular fractures of the calcaneus in 35 patients were fixed with 3.5mm cannulated screws and percutaneous 2.5mm K-wires. The extensile lateral approach was used in all cases. The average follow-up period was 16 months. Clinical evaluation was assessed according to the Ankle-Hind Foot Scale of American Orthopedic Foot and Ankle Society. Results: The clinical results were graded as excellent in 8 cases(21%), good in 22 cases(58%), fair in 6 cases(16%), and poor in 2 cases(5%). Two cases of poor result were type IV of Sanders classification. The postoperative reduction status of the articular surface was analyzed by computed tomography in all cases and was found to be less 2mm of step off in 30 cases and between 2 and 4mm in 8 cases. Unsatisfactory results were correlated with severity of articular comminution and failure to obtain accurate reduction of the articular surface. Using early functional postoperative care, all fractures healed without secondary displacement except 1 case on an average of ten weeks. Two cases had superficial necrosis of the wound margins, however, secondary wound healing was uneventful and skin grafting was not needed. Conclusion: Combined minimal internal fixation and percutaneous pin fixation using extensile lateral approach is useful operative method of intraarticular calcaneal fractures because providing enough stability to permit functional aftercare and allowing excellent anatomical reduction. In addition, this method diminishes the risk of lateral soft tissue problems.

• Nuclear Medicine and Molecular Imaging
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• 제41권1호
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• pp.54-58
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• 2007

목적: Firefly luciferase (이하 Fluc)는 분자영상 분야에 가장 널리 쓰이는 리포터 유전자 중 하나이다. 발광반응의 기질로 사용되는 D-luciferin 은 가격이 비싸고 실험동물의 무게에 비례해서 기질을 주입 하므로 마우스나 렛트와 같은 소동물을 대상으로 전임상 연구가 이루어지고 있다. 본 실험실에서는 중동물인 토끼의 관절강에 D-luciferin을 국소 주입하여 발광영상을 획득하였다. 대상 및 방법: 연골세포를 일주일 동안 배양한 후 Fluc 아데노바이러스에 감염시켰다. 감염된 연골세포를 토끼의 관절강에 주입 또는 이식하였다. 착상된 무릎의 관절강부위에 D-luciferin을 국소 주입한 후 본 실험실서 보유하고 있는 CCD 카메라가 장착된 실시간 영상장비를 이용하여 날짜 별로 분자영상을 획득하였다. 결과: 착상되어진 토끼의 관절강 부위에 기질을 국소주입하여 영상을 성공적으로 획득하였다. 연골세포 주입 및 이식 후 1일째부터 토끼의 관절강에서 빛이 방출되었으며 토끼의 관절강에 주입하는 것보다 이식하는 방법이 강한 빛을 방출함을 알 수 있었다. 또한 7일째까지 토끼의 관절강에 연골세포를 이식한 것이 주입한 것보다 총 광량이 5배에서 10배까지 강하게 나타남을 확인하였고 9일째에는 약 10배정도 강하게 나타났다. 결론: 중동물인 토끼를 이용하여 Fluc을 발현하는 연골세포를 주입 또는 이식한 관절강에 D-luciferin을 국소 주입하여 영상을 성공적으로 획득하였으며, 이러한 결과를 통해 중동물에 소량의 D-luciferin 국소주입하여도 발광영상을 얻는데 충분함을 알 수 있었다.

• The Korean Journal of Pain
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• 제18권2호
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• pp.198-203
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• 2005

Background: This study was designed to demonstrate the peripheral effect of ketamine on the synovia of the knee joint and evaluate the analgesic effect of an intraarticular ketamine injection following knee arthroscopy. Methods: In a double blind randomized study, 80 ASA class 1 or 2 patients were selected for elective arthroscopic knee surgery. The patients received either 20 ml of normal saline (Group C, n = 19), 20 ml of 0.5% ropivacaine (Group R, n = 21), 1 mg/kg of ketamine mixed with 20 ml of normal saline (Group K, n = 20) or 1 mg/kg of ketamine mixed with 20 ml of 0.5% ropivacaine (Group RK, n = 20), intraarticularly, just prior to wound closure. Postoperative pain was evaluated using a visual analogue scale (VAS 0 to 100) score at 1, 2, 6, 12, 24 and 48 hours after the intraarticular injection, with the side effects found in the four groups also evaluated. The patients' requests for rescue analgesic were recorded, total doses of tarasyn calculated and the overall patient satisfaction also evaluated. Results: The difference in the VAS scores for all time periods was not significant. The number of patients receiving rescue analgesics and the total doses received in Group C were greater than those for the other groups, but this was not significant. No side effects were observed in any of the patients. Conclusions: Ketamine and local anesthetics have been reported to have peripheral analgesic effects, with variable duration in the measurements of pain and hyperalgesia. However, we failed to demonstrate a peripheral analgesic effect on postoperative arthroscopic pain.

• 대한족부족관절학회지
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• 제14권1호
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• pp.58-65
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• 2010

Purpose: This study was performed to evaluate the clinical outcomes of operative treatment using porous hydroxyapatite for intraarticular calcaneal fracture of joint depression type. Materials and Methods: Twenty patients with intraarticular calcaneal fracture were followed up for more than 1 year. The period to union was calculated to evaluate the osteoconductivity of porous hydroxyapatite used as bone graft substitute. The measurement of Bohler angle, Gissane angle and the degree of articular surface depression was performed through preoperative and postoperative radiographs. The clinical evaluation was performed according to hindfoot score of the American Orthopaedic Foot and Ankle Society (AOFAS) and scale of the Creighton-Nebraska health foundation (CNHF). Results: Bohler angle and Gissane angle had improved significantly from preoperative average $10.4^{\circ}$, $117.8^{\circ}$ to average $22.6^{\circ}$, $113.5^{\circ}$ immediate postoperatively, and had maintained to average $21.2^{\circ}$ and $114.4^{\circ}$ at the last follow-up. The degree of articular surface depression had improved significantly from preoperative average 4.8 mm to 1.5 mm at the last follow-up. All cases achieved bone union, and the interval to union was average 12.8 weeks. AOFAS score was average 85.2 points at last follow-up. There were 7 excellent, 10 good, and 3 fair results according to the CNHF scale. Therefore, 17 cases (85%) achieved satisfactory results. Conclusion: Plate fixation using porous hydroxyapatite seems to be one of effective treatment methods for intraarticular calcaneal fracture of joint depression type, because of supporting the reduction of subtalar articulation by augmenting bony defect and facilitating bone formation. Further evaluation about long-term radiological changes and histological analysis on hydroxyapatite implantation site should be required.

• 대한정형외과스포츠의학회:학술대회논문집
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• 대한정형외과스포츠의학회 2001년도 제11차 학술대회
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• pp.27-28
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• 2001

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 1999년도 학술대회
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• pp.18-18
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• 1999