• 대한정형외과학회지
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• 제56권3호
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• pp.253-260
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• 2021

목적: 일차 슬관절 전치환술 시에는 일반적으로 가능한 한 구속력이 적은 치환물을 이용한 슬관절 전치환술이 권장된다. 그럼에도 불구하고 후방 십자인대 보존형 혹은 대치형 치환물로 적절한 슬관절 안정성을 얻기가 불가능한 경우에는 수술 중 내·외반 구속형 슬관절 치환물로 전환을 고려해야 한다. 내·외반 구속형 치환물이 항시 구비되어 있지 않는 국내 현실을 감안하여 일차 슬관절 전치환술의 효율적인 술 전 계획을 위해 내·외반 구속형 슬관절 치환물을 준비하는 적응증을 제시하고자 본 연구를 시행하였다. 대상 및 방법: 2003년 5월부터 2016년 2월까지 시행되었던 일차 슬관절 전치환술 1,797예 중 내·외반 구속형 슬관절 치환물로 일차 슬관절 전치환술이 시행되었던 27명(29예)를 대상으로 내·외반 구속형 슬관절 치환물로 최종 결정한 원인 등을 후향적으로 분석하였다. 결과: 일차 슬관절 전치환술 시 내·외반 구속형 슬관절 치환물이 사용된 경우는 전체 일차 슬관절 전치환술 중 29예로 1.6%의 빈도를 보였다. 남자 6명, 여자 21명이었으며, 2명에서 양측 모두 내·외반 구속형 치환물이 필요하였다. 환자의 나이는 평균 63.4세(34-79세)였고, 술 전 최대신전각도는 평균 16.2° (-20°-90°), 최대굴곡각도는 평균 111.7° (35°-145°)였다. 일차 슬관절 전치환술 시 내·외반 구속형 치환물이 필요하였던 원인으로는 심한 외반 변형으로 내·외반 불안정성을 보강하기 위한 경우가 10예, 심한 강직으로 인해 내·외반 구속형 치환물이 사용되었던 경우가 10예였으며, 과거력상 내측측부인대 4예, 외측측부인대 1예, 원위 대퇴골과의 무혈성 괴사로 인한 경우가 4예였다. 심한 외반 변형으로 수술을 시행한 10예 경우의 술 전 슬관절 전후방기립 사진상 해부학적 대퇴경골간각은 평균 25.7° (21°-43°)의 외반각을 보였고, 심한 강직으로 수술을 시행한 10예 경우의 굴곡 구축은 평균 37.5° (20°-90°), 관절운동범위는 평균 48.5° (10°-70°)였다. 결론: 20° 이상의 해부학적 대퇴경골간각의 외반 변형, 굴곡 구축 20° 이상 및 관절운동범위 70° 이하를 가진 관절운동 제한, 과거 측부인대 손상 병력이 의심되는 경우에는 일차슬관절 전치환술 시라도 술 전 계획 시 내·외반 구속형 치환물을 준비하는 것이 수술 중 발생할 수 있는 불안정성의 해결에 도움이 될 것으로 생각된다.

• The Journal of Korean Physical Therapy
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• 제26권2호
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• pp.117-122
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• 2014

Purpose: The purpose of this study was to compare the effects of force of ipsilateral versus contralateral cane usage on knee moments in healthy young adults. Methods: A convenience sample of 10 subjects volunteered for this study. Subjects walked over a force plate under three different conditions; unaided and ipsilateral cane and contralateral cane. Analysis of data on moment of the knee joint and ground reaction force was performed using the OrthoTrak program. Results: Flexion moment of the knee was decreased with the contralateral cane, but increased with the ipsilateral cane compared with normal gait. Extension moment of the knee was decreased with the contralateral cane compared with normal gait(p<0.05) and it was showed a greater decrease with the contralateral cane than with the ipsilateral cane gait(p=0.00). Valgus moment of the knee joint was increased with the ipsilateral cane but decreased with the contralateral cane. Vertical ground peak force was decreased with the ipsilateral cane compared with normal gait (p<0.05). Conclusion: The following conclusions were drawn from our data. Contralateral cane gait is more efficacious for persons with weakness of knee extensors, however, for a patient with varus deformity, the cane should be used in the ipsilateral hand.

• 한국가금학회지
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• 제22권4호
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• pp.213-221
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• 1995

Five experiments were conducted to evaluate the effect of dietary supplemental folic acid(FA) in starting broiler chicks. In the first two experiments, basal diets based on corn and soybean meal contained 0.6 mg/kg FA but no supplemental methionine or choline. At 18 d of age, chicks showed curvilinear responses to folic acid supplementation with maximum growth and feed efficiencies at 1.45 mg/kg FA diet. The liver FA response was also curvilinear but reached a plateau at 1.70 mg/kg FA diet. The basal diet for 3 additional experiments contained soybean meal that had been washed with methanol to remove most of the choline. The diet contained only 0.6 mg /kg folic acid and 754 mg /kg choline. Chicks exhibited a larger growth response to folic acid at low choline levels as evidenced by a significant FA x choline interaction. FA supplementation increased but then decreased valgus leg deformity. Choline supplementation also decreased the incidences of valgus and varus leg deformities and decreased bone ash and increased the incidence of tibial dyschondroplasia. It is concluded that chicks fed diets based on practical ingredients require from 1.45 to 1.70 mg /kg FA diet and also 1.60 mg/kg FA when choline is offered near the NRC recommended level of 1,300 mg/kg.

• Animal Bioscience
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• 제36권9호
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• pp.1393-1402
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• 2023

Objective: In this study effects of three types of beddings on broiler leg health and bone biomechanics were evaluated. Methods: A total of 504 male chicks (Ross 308) were randomly placed on three beddings (4 replicates/group; 42 birds/pen), zeolite-added litter (ZL), plastic-grid flooring (PF), and wood shavings (WS). On day 42, chickens were weighed, slaughtered, and samples (bone, muscle, and drumstick) were collected. Bones were subjected to leg health tests, morphometric measurements, biomechanical testing, and ash analysis. Results: Broilers in PF and WS groups showed higher live weight than the ZL group (p<0.001), and the incidence of tibial dyschondroplasia (TD) and varus valgus deformity due to distal bending was significantly higher in PF (p<0.001). Multinomial logistic regression showed that bedding has a significant (p = 0.038) contribution toward the development of TD. Tibial strength (p = 0.040), drumstick width (p = 0.001), and total femur and epiphyseal ash contents (p = 0.044, 0.016) were higher in the ZL group. Chicken live weight was correlated with tibial length and weight (r = 0.762, 0.725). Conclusion: Flooring and the type of bedding material directly affect broiler bone length, strength and leg health. Plastic bedding improves the slaughter weight of chickens on the expense of leg deformities, and zeolite litter improves leg health and bone strength.

• Clinics in Shoulder and Elbow
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• 제21권3호
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• pp.151-157
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• 2018

Background: Nonunion of lateral humeral condyle fracture causes cubitus valgus deformity. Although corrective osteotomy or osteosynthesis can be considered, there are controversies regarding its treatment. To evaluate elbow joint biomechanics in non-united lateral humeral condyle fractures, we analyzed the motion of elbow joint and pseudo-joint via in vivo three-dimensional (3D) kinematics, using 3D images obtained by computed tomography (CT) scan. Methods: Eight non-united lateral humeral condyle fractures with cubitus valgus and 8 normal elbows were evaluated in this study. CT scan was performed at 3 different elbow positions (full flexion, $90^{\circ}$ flexion and full extension). With bone surface model, 3D elbow motion was reconstructed. We calculated the axis of rotation in both the normal and non-united joints, as well as the rotational movement of the ulno-humeral joint and pseudo-joint of non-united lateral condyle in 3D space from full extension to full flexion. Results: Ulno-humeral joint moved to the varus on the coronal plane during flexion, $25.45^{\circ}$ in the non-united cubitus valgus group and $-2.03^{\circ}$ in normal group, with statistically significant difference. Moreover, it moved to rotate externally on the axial plane $-26.75^{\circ}$ in the non-united cubitus valgus group and $-3.09^{\circ}$ in the normal group, with statistical significance. Movement of the pseudo-joint of fragment of lateral condyle showed irregular pattern. Conclusions: The non-united cubitus valgus group moved to the varus with external rotation during elbow flexion. The pseudo-joint showed a diverse and irregular motion. In vivo 3D motion analysis for the non-united cubitus valgus could be helpful to evaluate its kinematics.

• 대한골관절종양학회지
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• 제11권1호
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• pp.100-104
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• 2005

원발성 악성 골종양중에서 가장 흔한 골육종은 10세에서 14세사이에 호발하며, 6세이하에서는 발병이 드문 것으로 알려져 있다. 문헌고찰에 의하면 지금까지 보고된 최소 연령의 골육종환자는 13개월된 여아로써 제2 중수골에 발생한 골육종이었다. 저자들은 생후 8개월된 남아의 우측 근위 경골에 발생한 골육종에 대한 치험례를 보고하고자 한다. 환아는 광범위 절제술 및 동종골 이식술을 시행하였으며 술 후 20개월에 동종골 이식편 근위 접합부에 내반 변형이 나타나서 변형교정 및 근위 비골 전이술을 시행하였다. 술 후 51개월의 추시관찰에서 잔류 병변은 보이지 않았으며 슬관절 운동범위는 15도에서 75도로 측정되었다. 영유아의 골육종은 매우 드물지만 감별진단으로 고려해야 할 것이며 수술적 치료에서 절단술 대신 사지 보존술도 가능하며 향후 발생할 수 있는 하지 부동에 대한 해결방안을 고려하여야 할 것으로 사료되었다.

• 대한골관절종양학회지
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• 제6권2호
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• pp.106-111
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• 2000

국소적 섬유연골성 이형성증(FFCD)은 소아에서 일측성 경골 내반 소견을 보이는 드문 양성 질환이다. FFCD는 근위 경골 내측 골간단과 골간의 이행부에 오목한 방사선 투과 음영 소견을 보이는 전형적인 방사선 소견을 지니고 있다. 경골 내반이 병변 부위에서 발생한다. 내반의 교정과 골결손의 치유가 흔히 자발적으로 일어나기도 하지만 골교정술을 요하기도 한다. 저자들은 절제 조직 생검술로 진단하고 절골술 및 골이식술을 시행함으로써 치유한 FFCD에 의한 일측성 경골 내반 1예를 문헌고찰과 함께 보고하는 바이다.

• 대한족부족관절학회지
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• 제9권1호
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• pp.81-86
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• 2005

중등도 이상의 변형을 보인 무지 외반증 치료에서 McBride씨 변형 술식과 근위 중족골 반월형 절골술은 만족스러운 결과를 보이는 치료 수단이나 신중한 환자 선택과 세심한 술기가 요구된다.

• 대한족부족관절학회지
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• 제20권1호
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• pp.27-31
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• 2016

Purpose: Several techniques have been introduced for correction of pes cavo-varus deformity. We retrospectively reviewed and compared the data of patients who underwent 1st metatarsal osteotomy alone, Dwyer's osteotomy alone, and 1st metatarsal osteotomy combined with Dwyer's osteotomy to determine the effect on radiographic parameters. Materials and Methods: Data on 28 cases in 27 consecutive patients recruited from 2006 to 2014 who underwent 1st metatarsal osteotomy alone (group F), Dwyer's osteotomy alone (group H), or 1st metatarsal osteotomy followed by Dwyer's osteotomy (group HF) with a minimum 1-year follow-up were reviewed retrospectively. Results: Calcaneal pitch angle on the standing foot lateral radiographs was significantly decreased after the operation in groups H and HF whereas Meary angle was decreased in groups F and HF. Hindfoot alignment angle and ratio on the hindfoot alignment view were improved in groups H and HF. Maximal medial cuneiform height reduction was observed in group HF. 1st ray was significantly shortened in groups F and HF. Conclusion: Combined forefoot and hindfoot operation took the largest correction power of all radiologic parameters.

• Archives of Plastic Surgery
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• 제40권3호
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• pp.232-237
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• 2013

Background Polydactyly of the foot is one of the most frequent anomalies of the limbs. However, most classification systems are based solely on morphology and tend to be inaccurate and less relevant to surgical methods and results. The purpose of this study is to present our new classification of polydactyly of the foot, which can serve as a predictor of treatment and prognosis. Methods To find a correlation between the various morphologic traits of polydactyly of the foot and the treatment plan and outcomes, we reviewed 532 cases of polydactyly of the foot in 431 patients treated in our hospital, expanding on our previous study that described polydactyly based on the importance of metatarsal bone status and varus deformity. The records of patients were evaluated and compared with previous studies at other centers. Results Unsatisfactory results were seen in 36 cases, which included 5 cases of incomplete separation due to syndactylism, 23 cases of axis deviation, and 8 cases of remnants of extradigit metatarsal bones. The locus of the polydactyly, or the digit which was involved, did not seem to affect the final postoperative outcomes in our study. Three factors-syndactylism, axis deviation, and metatarsal extension-are the major factors related to treatment strategy and prognosis. Therefore, we developed a new classification system using three characters (S, A, M) followed by three groups (0, 1, 2), to describe the complexity of polydactyly of the foot, such as $S_1A_2M_2$. Conclusions Our new classification could provide a communicable description to help determine the surgical plan and predict outcomes.