• 대한정형외과학회지
• /
• 제55권2호
• /
• pp.135-142
• /
• 2020

목적: 본 연구에서는 봉합 불가능한 광범위 회전근 개 파열에 있어서 상완 이두근 건 장두를 이용한 관절경하 부분 봉합술의 임상적 유용성 및 장기 추시 결과를 발표하고자 한다. 대상 및 방법: 봉합 불가능한 광범위 회전근 개 파열 환자 중 상완 이두근 건 장두에 50% 미만의 파열이 있는 41명의 환자를 대상으로 상완 이두근 건 장두를 이용하여 관절경하 부분 봉합술을 시행받은 1군과 파열되지 않은 상완 이두근 건 장두가 있으나 자가 이식건을 이용하지 않고 관절경하 부분 봉합술만을 시행한 2군으로 나누었다. 임상 점수는 시각통증점수(visual analogue pain scale, VAS), 운동범위(range of motion, ROM), The University of California, Los Angeles shoulder score (UCLA), American Shoulder and Elbow Surgeons Shoulder Score (ASES) 및 Korean Shoulder Scoring System (KSS) 점수로 측정하였으며 최종 추시에 측정된 점수가 사용되었다. 수술 전과 최종 추시에 촬영한 단순 방사선 사진을 이용하여 견봉상완거리(acromiohumeral interval, AHI)를 측정하였고 최종 추시에 시행한 초음파 또는 자기공명영상 검사를 이용하여 재파열 여부를 평가하였다. 결과: 환자의 평균 연령은 62.1±12.7세였으며, 평균 추시 기간은 90.3±16.8개월이었다. 1군과 2군 간에 VAS와 ROM (전방 거상, 외회전, 내회전)의 유의한 차이는 없었다(p=0.179, p=0.129, p=0.098, p=0.155). UCLA, ASES 및 KSS 점수는 2군과 비교해 1군에서 기능적 개선을 보였다(p=0.041, p=0.023, p=0.019). 최종 추시 시 AHI는 1군 9.46±0.41 mm, 2군 6.86±0.64 mm로 측정되었다(p=0.032). 재파열은 1군 21예 중 6예(28.6%), 2군 20예 중 9예(45.0%)에서 발견되었다. 1군의 경우 2군에 비하여 유의하게 낮은 재파열률을 보였다(p=0.011). 결론: 본 연구에서는 봉합이 불가능한 광범위 회전근 개 파열이 있는 환자들에게 상완 이두근 건 장두를 이용한 관절경하 부분 봉합술을 시행하여 장기 추시한 결과, 상완 이두근 건 장두를 사용하지 않은 군에 비하여 기능적 향상 및 낮은 재파열률을 보인다. 따라서 이는 봉합 불가능한 광범위 회전근 개 파열이 있는 환자에서 좋은 수술적 방법으로 생각된다.

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 1995년도 학술대회
• /
• pp.13-13
• /
• 1995

The authors performed the arthroscopic decompression and cuff debridement on 47 cases in 45 consecutive patients with either stage II or stage III impingement syndrome from July 1990 to January 1994. The summarized results are as follows. 1. 47 cases in 45 consecutive patients had arthroscopic decompression for the subacromial impingement syndrome. 2. There were 31 males and 14 females and the mean age was 40 years for men and 46years for women. 3. The follow up duration was from 3 years 9 months to 1 year (average 2 years 1month). 4. Among 47 cases, 19 cases were found to have no cuff tear (stageII) 13 cases partial thickness cuff tear (stage IIIa) 10 cases complete tear on cuff less than 3 cm long (stage IIIb) and 5 cases complete tear on cuff more than 3 em in length (stage IIIc). 5. The arthroscopic subacromial decompression and rotator cuff debridement was a good treatment method in stage II and stage IIIa and stage IIIb. in the case of stage IIIc rotator cuff tear, it was useful for pain relief and improvement of shoulder function.

• Journal of Korean Neurosurgical Society
• /
• 제37권2호
• /
• pp.141-145
• /
• 2005

We report five patients of esophageal injuries confirmed by clinical signs and radiological evidences. They include a partial tear and a perforation which were not noticed during the operation, a perforation which was primarily repaired during the operation, and two perforations which occurred during the reoperations for the removal of mal-positioned screws or plate. The partial tear was not repaired. The perforation which occurred during the operation was primarily sutured and didn't receive further treatment. Two perforations which occurred during the reoperations were treated by irrigation, debridement with surgical drainage, and systemic antiobiotics. One who was diagnosed later after the operation showed the poorest outcome and required longest hospital days among our series. Early detection and appropriate treatment of esophageal injury following anterior spinal surgery can only improve the prognosis by preventing secondary complications.

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2005년도 제13차 춘계학술대회
• /
• pp.1-1
• /
• 2005

• 대한관절경학회지
• /
• 제13권3호
• /
• pp.205-211
• /
• 2009

• 대한족부족관절학회지
• /
• 제21권1호
• /
• pp.12-16
• /
• 2017

Purpose: Anterior drawer and varus stress radiographs are commonly to diagnose chronic lateral ankle instability. We compared the preoperative stress radiographs with the intraoperative radiographs under anesthesia to determine the accuracy and efficacy of stress radiographs in an outpatient clinical environment. Materials and Methods: Data was collected from patients who underwent a modified $Brostr{\ddot{o}}m$ operation for painful chronic unilateral lateral ankle instability between January 2014 and June 2016. Subjects were divided into three groups-complete tear, partial tear, and instability without rupture-according to the status of preoperative MRI findings of the anterior talofibular ligament. The anterior drawer and varus stress radiographs were taken preoperatively and intraoperatively under anesthesia. Results: Ninety-six patients, with a mean age of 29.63 years, were enrolled. There were 39, 46, and 11 patients in the complete tear, partial tear, and instability without rupture groups, respectively. On the anterior drawer and varus stress radiographs of the affected limb, talar anterior translation and varus tilting were significantly increased by 2.56 mm and $2.0^{\circ}$. The gaps between the unaffected limbs were also increased by 2.47 mm and $1.32^{\circ}$ after anesthesia. Although the stress radiographs were taken under anesthesia, the results were often smaller than the diagnostic value. Conclusion: Stress radiographs for painful chronic lateral ankle instability taken at the outpatient clinic might be inaccurate for diagnosis.

• 대한약침학회지
• /
• 제14권2호
• /
• pp.61-74
• /
• 2011

This is a case report about effect of syeom pharmacopuncture, bee venom and autohemo-seperated regeneration pharmacopuncture(ASRP) for acute traumatic subdeltoid bursitis with partial tear of subscapularis tendon, which was diagnosed by symptoms and MRI(Magnetic resonance imaging) and caused by bongchuna treatment. We evaluated the patient using Visual Analogue Scale(VAS) every two or four days and range of movement(ROM), physical examination of shoulder about one per ten days and observed improvement with reexamination by ultrasonography and MRI as well. Pharmacopuncture rapidly reduced pain and improved range of motion and function of shoulder in patients with acute sub-deltoid bursitis even though it was severe symptom. Our result suggest that autohemo-seperated regeneration pharmacopuncture might be effective in regenerating the tear of soft tissue such as subscapularis tendon.

• Clinics in Shoulder and Elbow
• /
• 제8권1호
• /
• pp.9-13
• /
• 2005

An isolated tear of the subscapularis is uncommon, and there are a few literatures regarding the treatment of this problem. But, the incidence has increased with development of the arthroscopic techniques. An all-arthroscopic rotator cuff repair is a challenging procedure that can be effectively performed for treatment of subscapularis tendon tears. Often, tears of the subscapularis tendon do not involve entire tendon, and retraction of the torn edge is within to 2 cm of its attachment site. Occasionally, the entire tendon is torn and retracted medially to the glenoid. This article outlines the examination, preoperative planning and details the steps necessary to perform this procedure on upper third of subscapularis tears.

• 대한치과의사협회지
• /
• 제54권5호
• /
• pp.365-373
• /
• 2016

Purpose: Cemental tear is a specific type of root surface fracture characterized by a complete separation of a cemental fragment along the cementodentinal junction or a partial split within the cementum along an incremental line. It is suggested to be a factor for periodontal or periapical tissue destruction. The aim of this study is to present a diagnosis and treatment of cemental tear associated with periapical lesion with root canal treatment and regenerative periodontal surgery. Treatments: A 60-year-old male who had a history of sports trauma on the mandibular right central incisor about 10 years ago presented with apical cemental tear. Clinical examination showed a slightly dark yellowish discoloration and sinus tract that was located on the apical labial mucosa. The mobility and percussion were also assessed on the diseased tooth and recorded as $Miller^{\circ}{\phi}s$ Class II and tenderness to percussion. The probing depth was within the normal limit (<3 mm). Radiographic examination revealed a radiolucent lesion at the apical area and extended to distal aspect of the tooth along the fragment of cemental tear. After root canal treatment, periapical surgery was performed. The bony defect was exposed and then the detached root fragment was removed. Apical root resection and retrograde filling with Mineral Trioxide Aggregate (MTA) were accomplished and the bony defect was filled with deproteinized bovine bone mineral (DBBM) and covered with biodegradable collagen membrane. Results: After 9-month follow-up, healing of the mandibular right central incisor was uneventful and no swelling, purulence or pain was revealed in the associated area. Probing pocket depth was favorably stable, and the tooth mobility was decreased to the Miller's Class I. Conclusions: Apical cemental tear associated periapical lesion could be successfully treated with removal of the detached cementum in combination with apical surgery and GTR procedure.

• Journal of Preventive Medicine and Public Health
• /
• 제30권4호
• /
• pp.805-814
• /
• 1997

Injuries to the menisci occur in a variety of ways, most commonly with a twist, pivot, squat, or valgus stress to the knee. Tear patterns are classified to longitudinal, horizontal, or transverse features according to the mechanism of injury. Work-related meniscal tear usually occurs with a repetitive usage of the foot, hence it can be classified as a cumulative traumatic disorder. We found a 47 year-old female worker who had been taking charge of repetitive foot-switch stepping for 8 years. She suffered from pain in the right knee since 5 months ago. Tenderness along the medial joint line of the right knee was observed and pain was aggravated with full flexion of the right knee. On magnetic resonance imaging, high signal intensity was observed at the posterior horn of the medial meniscus of the right knee. Degenerative longitudinal and transverse complex tear in the medial meniscus was observed on arthroscopy. Arthroscopic partial meniscectomy was performed. We surveyed the work process and the health status of co-workers. It turned out that the work process was compatible to injure the meniscus and nine out of fourteen co-worker(64.3%) complained pain of the knee. No other factors related to her meniscal tear could be found except for the situation at her work. Therefore, we conclude that meniscal tear is related to the repetitive stepping of foot switch.