• 제목/요약/키워드: orthopedic

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거골의 골연골 병변에 대한 관절경적 골연골 성형술 (Arthroscopic Osteochondroplasty of the Osteochonral Lesion of the Talus)

  • 민상혁;정홍근;김유진;김영재;유문집
    • 대한족부족관절학회지
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    • 제10권2호
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    • pp.144-149
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    • 2006
  • Purpose: To evaluate the clinical characteristics and the functional results of the osteochondral lesions of the talus (OLT) treated with arthroscopic osteochondroplasty. Materials and Methods: The study was based on 25 cases (25 feet) of osteochondral lesion of talus that were treated with arthroscopic osteochondroplasty from May 1997 to June 2005 with at least 1 year follow-up. Follow-up period was average 21.8 months. The average age was 37.2 years old. Male patients were 22 while female were 3. Postoperative evaluation was performed with American Orthopedic Foot and Ankle Society (AOFAS) Functional score, patient satisfaction and complications. Results: Ninety-two percent of patients had trauma history. Seventy-two percent of the lesions were located at the medial dome. As for the cartilage classification, 56% were fibrillation/fissure lesions while 44% were flap tears. Visual analogue scale (VAS) pain score improved from 6.8 points to 2.2 points, and AOFAS score improved from 71.3 points to 87.3 points. Eighty-eight percent of the patients were satisfied with the surgery and average period of returning to previous job was 6.5 weeks. Conclusion: We concluded that the arthroscopic osteochondroplasty is a viable surgical option for the osteochondral lesion of the talus.

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연부조직 교정술에 의한 무지 외반증의 치료 (Treatment of Hallux Valgus with Modified McBride Method)

  • 최호;김훈;조형래;고영철;박영일;안수한
    • 대한족부족관절학회지
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    • 제7권1호
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    • pp.115-118
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    • 2003
  • Purpose: We are going to present a report from clinical and radiographic results of hallux valgus done only by soft-tissue procedure, when intermetatarsal joint is totally unfit under mild to moderate deformity. Materials and Methods: As a retrospective study, among all the patients who went under the surgery for hallux valgus, and of those who were possible to follow up,(excluding those whose intermetatarsal joint is fit) it was done over 28 cases (18 patients). the soft-tissue procedure was all done by Modified Mc Bride. Results: Hallux valgus angle and intermetatarsal angle each showed correction of $19.4^{\circ}$ and $5.2^{\circ}$, and from the final follow up, they were each decreased by $5.1^{\circ}$ and $1.5^{\circ}$. 21% (6case) were recurred, in one case, the intermetatarsal angle decreasing 120 and the other 5 case all decreased by $13^{\circ}$. Conclusion: when the intermetatarsal joint is unfit and there is no degenerative change, and, if the intermetatarsal angle is not large, moderate hallux valgus can show a good result, just by the distal soft-tissue procedure. a critical indication and a well through out preparation can reduce unneccessary surgeries.

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당뇨병성 족부 궤양에서 고 농도 은($Ag^+$) 도포 포말 드레싱을 이용한 전 접촉 석고 붕대 치료 결과 (The Result of Total Contact Cast with High Concentrate Silver ($Ag^+$) Coated Foam Dressing in Diabetic Foot Ulcers)

  • 김재영;최재혁;이경태;양기원;김진수;이재준
    • 대한족부족관절학회지
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    • 제10권2호
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    • pp.250-254
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    • 2006
  • Purpose: The treatment of diabetic foot ulcers with total contact cast has been reported to be associated with numerous undesirable complications. This study shows that our technique of total contact casting that incorporates high concentration silver coated foam dressing. Materials and Methods: Forty-four diabetic foot ulcers were treated with total contact cast along with high concentration silver coated foam dressing. Complication and healing rates were evaluated. Results: Eighty five percent of the ulcers healed within 6 weeks with an overall complication rate of 7%. There were only two cases (5%) of infection and no recurrent ulceration and no another site new pressure ulcer in our study. Conclusion: Total contact casting incorporates high concentration silver coated foam dressing resulted in fewer complications rate and healing rate that is comparable to other studies.

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제5중족골 제1, 2구역 골절의 비수술적 치료 결과 (Results of Non-Operative Treatment of the Zone I, II Fifth Metatarsal Base Fracture)

  • 최영낙;최영락;서정호;이호승;김상우;정재중
    • 대한족부족관절학회지
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    • 제15권4호
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    • pp.207-211
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    • 2011
  • Purpose: To evaluate the results of conservative treatment of zone I, II $5^{th}$ metatarsal base fracture. Materials and Methods: Between May 2004 and June 2010, a total of 58 patients of zone I, II $5^{th}$ metatarsal base fractures were included in this study. The mean length of follow-up was 13.5 months (12~36 months). All of the patients were treated with full-weight-bearing short leg cast immobilization for 4 weeks and wooden sole shoes for 4 weeks. The results were evaluated about the radiographic union, the midfoot scale of American Orthopaedic Foot and Ankle Society (AOFAS), the tenderness on fracture site and other complications. Results: All patients were able to return to their prior levels of activity. The mean time for union as shown on radiographs was 45.5 days, and the mean midfoot scale of AOFAS was 99.7 points. There were no nonunions or refractures during the follow-up. Conclusion: The conservative treatment with full-weight-bearing short leg cast and wooden sole shoes seems to give good results for zone I, II $5^{th}$ metatarsal base fracture.

급성 아킬레스건 파열의 수술적 치료: 경피적 봉합술과 관혈적 봉합술의 비교 (Surgical Treatment of the Ruptured Achilles Tendon: A Comparative Study between Percutaneous and Open Repair)

  • 김도연;김상범;허윤무;이정범;임재우;오형탁
    • 대한족부족관절학회지
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    • 제15권2호
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    • pp.79-85
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    • 2011
  • Purpose: The purpose of the present study was to compare and analyze the clinical outcomes of the percutaneous and open repair of acute Achilles tendon ruptures. Materials and Methods: We performed a retrospective study on 24 patients (group 1) managed with percutaneous repair, and 21 patients (group 2) managed with open repair for acute Achilles tendon rupture. The postoperative evaluations were done by an Arner-Lindholm scale and AOFAS score. Postoperative overall satisfaction and cosmetic satisfaction were also evaluated. Results: By Arner-Lindholm scale and AOFAS score, there was no difference between two groups (p<0.05). As for postoperative overall satisfaction, 5 cases were very satisfied, 16 cases were satisfied and 3 cases were fair in group 1. In group 2, 12 cases were very satisfied, 9 cases were satisfied. For postoperative cosmetic satisfaction, 13 cases were satisfied, 11 cases were fair in group 1. In group 2, 9 cases were very satisfied, 12 cases satisfied. In open repair group, a case of deep wound infection and three cases of skin necrosis were reported as complication. 2 cases of sural nerve injury were seen in percutaneous repair group and were recovered within 3 months. Conclusion: Percutaneous repair of acute Achilles tendon ruptures have high level of cosmetic satisfaction compared with open repair without any significant difference in clinical outcomes.

종골의 관절내 골절 후 발생한 불유합의 수술적 치료 (Operative Treatment of Nonunion after Intra-articular Calcaneal Fracture)

  • 은일수;정철용;김진완;고영철;허정욱
    • 대한족부족관절학회지
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    • 제13권1호
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    • pp.85-90
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    • 2009
  • Purpose: Nonunion of intra-articular fractures of calcaneus is rarely reported complication. We present our experiences with 4 patients (5 cases) treated operatively for nonunion after intra-articular fracture of calcaneus. Materials and Methods: 4 patients (5 cases) with nonunion of intra-articular fracture of calcaneus after operative treatment were followed for 4 years (from 2002 to 2006). For assessment, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and Visual Analogue Scale (VAS) were assessed for clinical outcome and the union of fracture site, the talocalcaneal height and the angle of talar declination were determined for radiologic outcome. Results: The mean talocalcaneal height was 6.94 cm (range, 5.9${\sim}$7.6 cm) preoperatively and 7.34 cm (range, 6.0${\sim}$8.3 cm) at last follow-up. The mean angle of talar declination was 5.68 degrees (range, 4.6${\sim}$8 degrees) preoperatively and 13.1 degrees (range, 5.7${\sim}$21 degrees) at last follow-up. The mean preoperative AOFAS score and VAS were 20.4 (range, 14${\sim}$36) and 4 (range, 3${\sim}$6), respectively. At last follow-up, these scores improved to a mean of 59.6 (range, 54${\sim}$68) and 3 (range, 2${\sim}$4), respectively. Unions of previous nonunion site of intra-articular fracture of calcaneus were achieved in all 4 patients (5 cases). Conclusion: The reconstructive procedure for nonunion of intra-articular fracture of calcaneus showed good results in terms of bone union, radiologic results and functional improvement than preoperative state. Because the plantar pain for the inferior angular formation in nonunion site may happen, we will pay attention to reduction of fragment.

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한국 정상 젊은 남성에서의 제 4-5 중족골간 각 및 제 5 근위-종족골간 각 (The $4^{th}-5^{th}$ Intermetatarsal Angle and the $5^{th}$ Metatarsophalangeal Angle of Young Men in Korea)

  • 이경태;이영구;임수재;양기원;박신이;김형태
    • 대한족부족관절학회지
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    • 제13권1호
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    • pp.46-49
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    • 2009
  • Purpose: The purpose of this study is to find out the normal angles of forefoot for diagnosis of bunionette deformity in Korea. This would be helpful as it would provide a basic angular measurement of bunionette deformity that indicates the need for operation. Materials and Methods: Within a period of four months from January 2007 to April 2007. We have established 300 males and 600 feet without trauma history of foot. The source to image distance is 40 inches and erect weight bearing radiographs are obtained in anteroposterior and lateral projections. The significant angular measurements that define a bunionette deformity are the fourth-fifth intermetatarsal angle, the fifth metatarsophalangeal angle Results: The mean age was 21 years(19-22 years) old. The mean $4^{th}-5^{th}$ intermetatarsal angle was $9.4{\pm}4.7^{\circ}$, the mean $5^{th}$ metatarsophalangeal angle was $7.9{\pm}9.2^{\circ}$. Conclusion: We can consider over the $14.1^{\circ}$ on the $4^{th}-5^{th}$ intermetatarsal angle and over $17.1^{\circ}$ on the $5^{th}$ metatarsophalangeal angle as an operational indication.

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관절 내 종골 골절의 수술적 치료에 있어 관절 내시경 사용의 유용성 (The Usefulness of Arthroscopy in the Operative Treatment of Intra-Articular Calcaneal Fracture)

  • 정경칠;곽희철;김창완;김정한;박대현
    • 대한족부족관절학회지
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    • 제13권1호
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    • pp.55-59
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    • 2009
  • Purpose: We tried to evaluate the usefulness of the arthroscopy in the operative treatment of intra-articular calcaneal fracture. Materials and Methods: Between March 2005 and May 2008, 9 patients with intra-articular calcaneal fractures(Tongue type or Sanders type IIC) were treated with arthroscopically assisted percutaneous reduction and screw fixation. American orthopedic foot and ankle society (AOFAS) ankle-hindfoot score, visual analogue scale (VAS), preoperative and postoperative Bohler's angle and the rate of complication were evaluated. Results: AOFAS score at postoperative 1 year was 88.2 (range, 71-92), and mean VAS score was 2.8 (range, 1-4). Bohler angle was improved from preoperative mean $16.2^{\circ}$ to postoperative mean $29.7^{\circ}$. There were no complications such as wound problem, infection or nerve injury. Conclusion: Subtalar arthroscopy provides precise view of posterior facet during the operation. Therefore, it can be a useful tool in treating intra-articular calcaneus fractures, especially tongue type and Sanders type IIC fractures.

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족근골 유합의 발생 빈도: 단일 기관 자기공명영상 분석 (Incidence of Tarsal Coalition: An Institutional Magnetic Resonance Imaging Analysis)

  • 김정한;곽희철;이창락;김영준;김전교;이선주;이정한;박준호
    • 대한족부족관절학회지
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    • 제20권3호
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    • pp.116-120
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    • 2016
  • Purpose: Tarsal coalition results from defects during the developmental stage and produes ankle pain and limitations in the range of motions. Its incidence has been reported to be 1%, but there has not been any reports with respect to Koreans. Therefore, we evaluated the prevalence of tarsal coalition in Koreans. Materials and Methods: Between 2005 and 2014, we analyzed a total of 733 cases of foot and ankle magnetic resonance imaging (MRI) in our hospital. There were 391 men and 342 women. All MRI readings were read by a radiologist in our hospital. We classified the coalitions in accordance with the histological and anatomical characteristics, and calculated the prevalence in each group. Moreover, we tried to determine the prevalence of tarsal coalitions in accordance with sex, age, and proportion of the symptomatic tarsal coalitions. Results: There were a total of 11 MRIs of tarsal coalition - 9 talocalcaneal coalitions, 1 calcaneocuboidal coalition, and 1 calcaneonavicular coalition. Nine tarsal coalitions were observed in men and 2 in women. Conclusion: Through this study, we found that the prevalence of tarsal coalition, including the asymptomatic patients, is similar to the previously known prevalence (1%). By getting more MRIs of the foot and ankle, we could better represent the prevalence of tarsal coalitions in Koreans.

관절과 상완 관절의 회전운동이 견갑흉곽 운동에 미치는 영향 (The Influence of the Glenohumeral Rotation on the Scapulothoracic Motion)

  • 서중배;최의성;원중희;김용민;이호승;김응록
    • Clinics in Shoulder and Elbow
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    • 제1권2호
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    • pp.186-192
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    • 1998
  • This study was performed to evaluate the influences of the passive glenohumeral rotation on the scapulothoracic motion. We took anteroposterior radiograms of the right shoulders including the thoracic vertebrae with supine position in 10 normal male adults, at 0 degree abduction, 45 degrees abduction and 90 degrees abduction in scapular plane and in neutral rotation, maximal internal rotation and maximal external rotation in each abduction view. The scapulothoracic motion was measured as the distances between the vertical line drawn from the spinous process of the 7th cervical vertebra and the inferior and superior angles of the right scapula respectively. At 0 degree abduction, the distances were not changed in internal rotation relative to neutral rotation, but decreased significantly in external rotation, that is, the scapula shifts medially on external rotation. At 45 degrees abduction, the distances were increased significantly only in internal rotation, that is, the scapula shifts laterally on internal rotation. At 90 degrees abduction, the scapula rotated laterally on internal rotation and medially on external rotation. In conclusion, when a physician examines the rotation of the shoulder joint, he cannot exclude the scapulothoracic motion just by examining the patient with supine position. And we concluded that the rotatory movement of the shoulder is not solely contributed to the glenohumeral motion.

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