• 제목/요약/키워드: orthopedic

검색결과 3,855건 처리시간 0.034초

비복 동맥 피판을 이용한 슬관절 주위의 연부 조직 결손의 치료 (Sural Artery Flap for the Treatment of Soft Tissue Defects around Knee Joint)

  • 배기정;이영호;김민범;이혁진;권지은;백구현
    • Archives of Reconstructive Microsurgery
    • /
    • 제21권2호
    • /
    • pp.143-148
    • /
    • 2012
  • Purpose: This report presents the authors' experience of twelve patients with sural artery flap for soft tissue defects around the knee joint. Materials and Methods: The patients' age ranged from 25 to 80 years; seven of the patients were male and five were female. The cause of soft-tissue defects involved wide excision for malignant soft tissue tumor, tumor prosthesis related infection, infection after total knee arthroplasty and chronic osteomyelitis. Postoperative range of motion was checked. The sensibility of flap was evaluated by Semmes-Weinstein monofilaments and two-point discrimination. Results: All flaps survived and provided satisfactory coverage of the defect. There was no complication except one delayed skin graft incorporation at donor site. Seven knee joints which had been stiff previously gained average 58 degrees of ROM postoperatively. All flaps retained sensibility and showed no significant increase in sensory thresholds comparing with contralateral side. Conclusion: Sural artery flap not only shows high survival rate and broad coverage ability, but also offers improvement in range of motion and preservation of sensation. We speculate that sural artery flap is valuable for the reconstruction of the soft tissue defects around knee joint.

  • PDF

Clinical and Radiological Results after Arthroscopic Superior Capsular Reconstruction in Patients with Massive Irreparable Rotator Cuff Tears

  • Yoon, Jeong Yong;Kim, Paul Shinil;Jo, Chris Hyunchul
    • Clinics in Shoulder and Elbow
    • /
    • 제21권2호
    • /
    • pp.59-66
    • /
    • 2018
  • Background: Massive, irreparable rotator cuff tears (RCTs) are a challenging clinical problem in young patients. In recent years, arthroscopic superior capsular reconstruction (ASCR) is a popular treatment in the massive, irreparable RCTs. However, studies reporting clinical results of ASCR are rare in the literature. Methods: Between 2013 and 2015, six patients underwent ASCR. One patient treated with dermal allograft, while five patients with autogenous fascia lata graft. Demographic data, as well as preoperative and last follow-up clinical data including pain, range of motion (ROM), strength, American Shoulder and Elbow Surgeons system, the Constant system, the University of California at Los Angeles system, the Simple Shoulder Test, and the Shoulder Pain and Disability Index system were obtained. Acromiohumeral distances and Hamada classification were measured on standard anteroposterior x-ray. Results: All patients were men, and the average age was $59.5{\pm}4.18years$ (range, 53-65 years).The minimum follow-up was 18 months with a mean follow-up was $27.33{\pm}7.58months$ (range, 18-36). All patients had postoperative improvement in pain scores and functional scores. The ROM and strength did not improve after surgery. The Hamada score progressed of radiographic stage in 2 patients. In the case of dermal allograft, there was graft failure 6 weeks after ASCR. Conclusions: Our results support the ASCR as a viable treatment for surgical salvage in massive, irreparable RCTs. This treatment option may provide patients with decreased pain and increased function. And studying our case of dermal allograft failure provides opportunities to decrease graft failure in ASCR using dermal allograft.

제 1 중족골 두 족저부 동통의 치료 (Treatments for the Plantar Pain of the First Metatarsal Head)

  • 박용욱;정영기;유정한;박홍준;유선오;김완홍
    • 대한족부족관절학회지
    • /
    • 제4권2호
    • /
    • pp.72-78
    • /
    • 2000
  • Purpose: To validate the major bony causes and postoperative results of the first metatarsal head plantar pain. Materials and Methods: We experienced one case of the fracture and non-union of the medial sesamoid treated by autogenous calcaneal bone graft, one case of the fracture and non-union and two cases of the hypoplasia of the medial sesamoid treated by excision of medial sesamoid, one case of the arthrosis between the first metatarsal head and the medial sesamoid treated by plantar 1/2 partial excision of the medial sesamoid, and two cases of the metatarsus primus nexus treated by basal metatarsal closing wedge osteotomy between October 1995 and September 1999. The mean follow-up period was 28 months. We evaluated the results by using of the clinical rating systems for the hallux and the radiographic findings. Results: An excellent results were achieved in all cases except one which was preoperatively diagnosed as metatarsus primus nexus. But, clinically this one case also satisfied with the postoperative result. Radiologically, We did not find the malunion or nonunion of the medial sesamoid treated by bone graft and of the metatarsus primus flex us treated by basal metatarsal closing wedge osteotomy. And also we did not find the postoperative fracture of the medial sesamoid treated by plantar 1/2 partial excision. There were no postoperative complications in all cases. Conclusion: We think that the good results may be achieved from the patients with the plantar pain of the first metatarsal head by the exact diagnosis and aggressive treatments.

  • PDF

증상을 동반한 비골하 부 골에 대한 임상적 방사선학적 분석과 해부학적 정복술 및 골 이식술 후 결과 (Clinical and Radiological Analysis and Results after Anatomical Reduction and Bone Graft for Symptomatic Os Subfibulare)

  • 황필성;김도영;박용욱;이상수;서동현;김형년
    • 대한족부족관절학회지
    • /
    • 제9권2호
    • /
    • pp.162-166
    • /
    • 2005
  • Purpose: To analyze the clinical and radiological feature of Os subfibulare and to evaluate the results after anatomical reduction and internal fixation with bone graft for Os subfibulare. Materials and Methods: Forty-two cases, which underwent anatomic reduction and bone graft for Os subfibulare from October 1998 to September 2004 were reviewed. We analysed preopertive symptoms and onset of symptoms and radiologically measured the size and amounts of displacement of Os subfibulare under the inversion stress. Postoperatively we evaluated the clinical results measured by Hasegawa method and evidence of union. Results: Preoperatively there were only pain around the lateral malleolus in 16 cases, only instability of ankle joint in 3 cases, and pain and instability in 23 cases. The age of symptom onset averaged 23 years(range, 13-38 years). Radiographically Os sufibulare anteriorly located from lateral malleolus were in 40 cases, posteriorly situated in 2 cases. The size of Os subfibulare ranged from $1{\times}4\;mm$ to $8{\times}17\;mm$. In 22 cases of inversion stress view, displacement of the Os sbufibulare averaged $1.5{\pm}1.1\;mm$ (0 to 5 mm). The postoperative clinical results were excellent in 41 cases, poor in 1 case. There were complications of 1 case of irritation of sural nerve, 1 case of nonunion. Conclusion: Anatomic reduction and bone graft is effective treatment method for symptomatic Os subfibulare.

  • PDF

한국인의 관상면상 원위 경골 관절면 각의 측정 (Distal Tibial Articular Surface Angle in the Coronal Plane in Koreans)

  • 이경태;김진수;양기원;김재영;차승도;김응수
    • 대한족부족관절학회지
    • /
    • 제10권1호
    • /
    • pp.56-59
    • /
    • 2006
  • Purpose: The purpose of this study is to find out the normal distal tibial articular surface angle in coronal plane in Koreans. This would be helpful as the basic data for ankle reconstruction after trauma or deformity correction. Materials and Methods: Weight bearing anteroposterior radiographs of 123 normal ankles were reviewed. A line parallel to the shaft of the tibia was made. Another line was drawn parallel to the articular surface of the distal tibia. The superolateral angle that subtended by these two lines was measured. Results: There were 72 males and 51 females. The mean age overall was 35.7 years old. The mean age for males was 31.9 ($28{\sim}36$) years old. The mean age for females was 41.1 ($37{\sim}45$) years old. The mean distal tibial articular surface angle was $90.8^{\circ}$. The mean distal tibial articular surface angle for males was $91.5^{\circ}$ and for females $89.9^{\circ}$. Conclusion: The mean distal tibial articular surface angle in coronal plane for Koreans is $90.8^{\circ}$. We can avoid the error of the varization at the ankle alignment when the correction was performed vertical or minimal valgus to tibia tuberosity axis in Korean people.

  • PDF