• 대한정형외과스포츠의학회지
• /
• 제10권2호
• /
• pp.69-77
• /
• 2011

목적: 만성 발목관절 외측 불안정성 환자에 대한 변형 Brostrom 술식에서 단일 봉합나사와 이중 봉합나사를 이용한 기법간의 임상 결과를 후향적으로 비교하고자 하였다. 대상 및 방법: 본원에서 봉합나사를 이용한 변형 Brostrom 술식을 시행받은 환자들 중 최소 1년 이상 추시가 가능하였던 37례를 대상으로 하였다. 모든 수술은 동일한 술자에 의해 이루어졌으며 단일 봉합나사를 이용한 경우가 17예, 이중 봉합나사를 이용한 경우가 20예 였다. 임상적 결과의 평가는 Karlsson 점수 및 Sefton의 평가법을 이용하였고, 발목관절의 기계적인 안정성에 대한 방사선학적 평가로 Telos 기기를 이용한 전방 전위 및 내반 스트레스 검사가 이용되었다. 결과: Karlsson 점수는 단일 봉합나사군이 술 전 평균 45.2점에서 술 후 89.4점으로, 이중 봉합나사군이 술 전 평균 46.4점에서 90.5점으로 각각 호전되었다. Sefton 평가법상 단일 봉합나사군은 우수가 7예, 양호가 8예, 보통이 2예 였고, 이중 봉합나사군은 우수 8예, 양호 10예, 보통 2예로 나타나 각각 15례(88.2%), 18례(90%)에서 만족스러운 결과를 보였다. 스트레스 방사선검사 상 거골 경사각과 거골 전방전위는 단일 봉합나사군이 술 전 평균 13.6도, 8.6 mm에서 술 후 최종 추시시 5.4도, 4.1 mm로, 이중 봉합나사군이 술 전 평균 14.1도, 8.4 mm에서 술 후 3.9도, 4 mm로 각각 호전되었으며 두 기법간에 술 후 거골 경사각의 유의한 차이를 보였다(p<0.05). 결론: 만성 발목관절 외측 불안정성에 대한 변형 Brostrom 술식에서 단일 봉합나사와 이중 봉합나사를 이용한 기법간에 술 후 임상 결과의 유의한 차이는 없었으나, 발목관절의 기계적인 안정성은 이중 봉합나사군에서 더 우수하였다. 단일 봉합나사와 이중 봉합나사를 이용한 변형 Brostrom 술식 모두 효과적인 치료 방법이라고 생각되며, 향후 운동 선수들을 대상으로 한 치료결과 및 생역학적 분석이 필요할 것으로 생각한다.

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2008년도 제16차 학술대회
• /
• pp.179-179
• /
• 2008

For a partial tear of the subscapularis tendon, the presenting technique requires only the anterior portal for preparing the footprint and suture management, as well as the subclavian portal for placing the suture anchor and suture hook without inserting a cannula. It provides both a good angle for anchor placement and sufficient space for managing the upper portion of a subscapularis tendon tear. A spinal needle was inserted through the subclavian portal in order to identify the appropriate angle for placing the suture anchor. A 3-mm incision was made for the subclavian portal and a biosuture anchor was placed on the footprint portion of the subscapularis tendon. In order to avoid crowding, each limb of both strands of the biosuture anchor were passed through the tendon- posteromedial side first, and anterolateral side second, using a switching technique with suture hook embedded with no.1 PDS. A suture tie was applied in a reverse sequence (the lateral strand first and the medial strand second) through the anterior cannula using a sliding technique.

• Clinics in Shoulder and Elbow
• /
• 제21권4호
• /
• pp.246-251
• /
• 2018

Compared to single row repair, use of lateral row anchors in suture bridge rotator cuff repair enhances repair strength and increases footprint contact area. If a lateral knotless anchor (push-in design) is inserted into osteoporotic bone, pull-out of the lateral row anchor can developed. However, failures of lateral row anchors have been reported at several months after surgery. In our cases, even though complete cuff healing occurred, delayed pull-out of the lateral row anchor in the suture bridge repair occurred. In comparison to a conventional medial anchor, further biomechanical evaluation of the pull-out force, design, and insertion angle of the lateral anchor is needed in future studies. We report three cases with delayed pull-out of lateral row anchor in suture bridge rotator cuff repair with a literature review.

• 대한족부족관절학회지
• /
• 제16권4호
• /
• pp.241-246
• /
• 2012

Purpose: The purpose of our study was to perform a comparison of the outcomes of the modified Brostrom procedure using only a suture anchor compared with using a suture anchor with a pushlock anchor. Materials and Methods: This was a retrospective study of chronic lateral ankle instability that underwent a modified Brostrom procedure using a bioabsorbable suture anchor & a pushlock anchor, performed by a single surgeon. A total of 88 patients were enrolled in the study. The function of the patient's ankles were scored using the American Orthopaedic Foot and Ankle Society (AOFAS), visual analogue scale (VAS) both preoperatively and postoperatively. Results: The difference in the overall means between the group A and group B was not statistically significant. But, the patient's satisfaction was better in the group B, and there were more complications in the group A. Conclusion: The technique presented here uses the modified Brostrom procedure with pushlock anchors to prevent the problems associated with subcutaneous knot irritation.

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2006년도 제14차 학술대회
• /
• pp.35-35
• /
• 2006

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2006년도 제14차 학술대회
• /
• pp.37-37
• /
• 2006

• 대한견주관절학회:학술대회논문집
• /
• 대한견주관절학회 2006년도 제14차 학술대회
• /
• pp.31-31
• /
• 2006

• Archives of Plastic Surgery
• /
• 제40권6호
• /
• pp.773-778
• /
• 2013

Background In the management of mallet deformities, oblique retinacular ligament (ORL) reconstruction provides a mechanism for automatic distal interphalangeal (DIP) joint extension upon active proximal interphalangeal joint extension. The two variants of ORL reconstruction utilize either the lateral band or a free tendon graft. This study aims to compare these two surgical techniques and to assess any differences in functional outcome. As a secondary measure, the Mitek bone anchor and pull-in suture methods are compared. Methods A single-institutional retrospective review of ORL reconstruction was performed. The standard patient demographics, injury mechanism, type of ORL reconstruction, and pre/postoperative degree of extension lag were collected for the 27 cases identified. The cases were divided into lateral band (group A, n=15) and free tendon graft groups (group B, n=12). Group B was subdivided into the pull-in suture technique (B-I) and the Mitek bone anchor method (B-II). Results Overall, ORL reconstructions had improved the mean DIP extension lag by $10^{\circ}$ (P=0.027). Neither the reconstructive technique choice nor bone fixation method identified any statistically meaningful difference in functional outcome (P=0.51 and P=0.83, respectively). Soft-tissue injury was associated with $30.8^{\circ}$ of improvement in the extension lag. The most common complications were tendon adhesion and rupture. Conclusions The choice of the ORL reconstructive technique or the bone anchor method did not influence the primary functional outcome of extension lag in this study. Both lateral band and free tendon graft ORL reconstructions are valid treatment methods in the management of chronic mallet deformity.

• 대한족부족관절학회지
• /
• 제15권2호
• /
• pp.72-78
• /
• 2011

Purpose: The purpose of this study is to compare the clinical outcome of excision versus osteosynthesis of type II accessory navicular performed by a single surgeon. Materials and Methods: Cases of 14 feet treated with excision and 13 feet by osteosynthesis for type II accessory navicular of 25 patients from 2002 to 2009 were included in this study. Radiological measurements and American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scale was evaluated. Results: AOFAS midfoot scale of both excision and osteosynthesis groups at last follow-up showed improvement from pre-operation. However, there was no statistical difference in AOFAS midfoot scale and subjective satisfaction between the two groups at last follow-up. In detail of AOFAS midfoot scale, pain and footwear requirements showed statistically favorable results for the excision group, while activity limitation and support showed statistically favorable results for the osteosynthesis group. Subjective recovery time returning to daily activities and starting rehabilitation exercise were 14.6 weeks in the excision group and 13.7 weeks in the osteosynthesis group (p=0.025, Mann-Whitney). Suture anchor loosening was observed in one case in the excision group and non-union in two cases in the osteosynthesis group. Conclusion: Both excision and osteosynthesis are favorable surgical methods, but each method has advantages and possible complications such as suture anchor loosening or non-union. Surgeon's preference, patient's chief complaint, specific needs of patient after the operation and consideration of the size of accessory navicular can be a criteria to consider when selecting a surgical method.