• 제목/요약/키워드: 거골

검색결과 140건 처리시간 0.027초

거골 박리성 골연골염의 관절경적 변연 절제술과 다발성 천공술의 비교 (Comparison of Arthroscopic Debridement and Multiple Drilling for Osteochondritis Dissecans of the Talus)

  • 김경태;김진학;이송;최대정;조근호;전영원
    • 대한관절경학회지
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    • 제9권2호
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    • pp.206-213
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    • 2005
  • 목적: 거골 박리성 골연골염에서 관절경적 단순 변연 절제술과 다발성 천공술을 이용한 치료의 유효성을 평가하고 그 결과를 비교하여 보고자 하였다. 대상 및 방법: 1997년 9월부터 2003년 12월까지 거골의 박리성 골연골염으로 진단되어 관절경적 수술을 시행한 후 1년 이상 추시가 가능했던 환자 29명(남자 21명, 여자 8명)을 대상으로 하였으며, 14명의 환자는 변연 절제술(I 군)을, 15명의 환자는 다발성 천공술(II군)을 시행하였다. 환자의 평균 나이는 34.4세(I군 33.8세, II군 37.5세)였고, 평균 추시기간은 43.2개월(I군 46.4개월, II군 40.1개월)이었다. 수술 전 단순 방사선 사진과 자기공명영상 검사를 촬영하고 관절경을 통해 병변의 진행 정도를 확인하였고, Ankle-hindfoot 점수와 주관적 및 객관적 기능 점수를 측정하여 그 결과를 비교하였다. 결과: 병변의 위치는 내측이 20예(I군 7예, II군 13예) 외측이 6예(I군 5예, II군 1예1)였으며 내외측에 모두 병변이 있는 경우가 3예(I군 2예, II군 1예)가 있었다. 병변의 진행정도는 Berndt 와 Harty의 분류상 II기가 4예(I군 4예, II군 0예), III기가 19예(I군 9예, II군 10예), IV기가 6예(I군 1예, II군 5예)였다. Ankle-hindfoot 점수는 술전 $53.9{\pm}5.2$점(I군 $53.1{\pm}2.7$점, II군 $54.6{\pm}6.8$점)에서 술후 $82.3{\pm}8.8$점(I군 $85.1{\pm}8.5$점, II군 $80.7{\pm}8.5$점)으로 향상되었으며, 주관적 및 객관적 기능 점수는 술전 $50.2{\pm}9.7$점(I군 $49.6{\pm}10.5$점, II군 $50.7{\pm}9.2$점)에서 술후 $83.8{\pm}8.6$(I군 $84.6{\pm}7.7$점, II군 $83.0{\pm}9.6$점)으로 향상되었다. 두 군 간의 비교에서 유의한 차이는 보이지 않았다. 결론: 관절경적 변연 절제술과 다발성 천공술은 두 군 모두에서 만족할만한 결과를 얻었으며 두 군 사이에 임상적 결과의 차이는 없었다.

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후방 삽입구를 이용한 관절경적 거골하 관절 유합술- 수술 방법- (Technical Note of Arthroscopic Subtalar Arthrodesis Using Posterior Portals - Operative Technique -)

  • 이근배;최진;박유복;서형연;서진수
    • 대한족부족관절학회지
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    • 제9권2호
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    • pp.193-196
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    • 2005
  • A posterior 3-portal arthroscopic approach with the patient in the prone position provides a novel and optimal approach for isolated subtalar arthrodesis. This approach facilitates access to the posterior talocalcaneal facet and facilitates safe access with regard to the posteromedial neuromuscular bundle. The technique involves prone positioning, establishment of two posterolateral portals and one posteromedial portal, arthroscopic posterior talocalcaneal facet debridement, percutaneous morcellized bone grafting and internal screw fixation. Preliminary results have shown high patient satisfaction, an excellent fusion rate and less postoperative morbidity than open subtalar arthrodesis.

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거골하 관절염으로 오인된 골관절 결핵 (1예 보고) (Osteoarticular Tuberculosis Misdiagnosed as Subtalar Osteoarthritis (A Case Report))

  • 이성준;이동철;김지훈;박강현;박철현
    • 대한족부족관절학회지
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    • 제17권3호
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    • pp.234-238
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    • 2013
  • Osteoarticular tuberculosis is often misdiagnosed as other disease because of a rare incidence and nonspecific clinical and radiographic presentation. Therefore, it is important to know clinical and radiographic presentations of osteoarticular tuberculosis and to diagnose in early phase. Especially, fistula formation is one of the most important clinical features which suspects osteoarticular tuberculosis. We report a case of ankle tuberculosis to be misdiagnosed as subtalar osteoarthritis and performed subtalar arthrodesis.

골(骨)스캔에 의한 거골(距骨)의 비패혈성(非敗血性) 괴사진단(壞死診斷) 예(例) (Diagnosis of Aseptic Necrosis of the Talus by Bone Scan; Case Report)

  • 박형근;이명철;고창순;양영식;박원창
    • 대한핵의학회지
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    • 제18권1호
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    • pp.63-65
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    • 1984
  • Bone scan is a very useful technique for detection of aseptic necrosis and frequently used in the detection of aseptic necrosis of the femoral head. We have used this diagnostic tool in a patient to detect aseptic necrosis of the talus, a common complication resulting from foot injuries.

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내측 활주 종골 절골술과 거골하 관절 제동술로 치료한 성인의 특발성 유연성 편평족 -1예 보고- (Adult Idiopathic Flexible Flat Foot Treated with Medial Sliding Calcaneal Osteotomy and Subtalar Arthroereisis -Report of 1 Case-)

  • 정홍근;변우섭;유문집
    • 대한족부족관절학회지
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    • 제8권2호
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    • pp.208-212
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    • 2004
  • There have been many reports about surgical treatments of flexible flatfoot in children and acquired adult flatfoot deformity due to posterior tibial tendon dysfunction common in the 5th and 6th decades. However there has been a controversy for surgical treatment guideline for painful idiopathic flexible flatfoot deformities in young adults. Therefore, we present a 27-year-old female with severe painful idiopathic flexible flatfoot who was treated with medial sliding calcaneal osteotomy and subtalar arthroereisis using $Kalix^{(R)}$ (Newdeal SA, Vienne, France) endoprosthesis and had good clinical outcome with high patient satisfaction at 10 months follow-up postoperatively.

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샌드위치 블록 경종골 관절 유합술을 이용한 거골 완전 탈출의 치료(1예 보고) (Treatment for Total Extrusion of the Talus (Missing Talus) using the Sandwich Block Tibiocalcaneonavicular Arthrodesis (A Case Report))

  • 이재훈;정덕환;정비오
    • 대한족부족관절학회지
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    • 제13권2호
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    • pp.230-232
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    • 2009
  • Total extrusion of the talus is a very rare injury. If the talus is found in a short time, it can be restored to its original position. If the talus is missing or found too late, however, surgeons may attempt tibiocalcaneal arthrodesis or use a pseudoarthrosis without repositioning the talus. As direct tibiocalcaneal arthrodesis may shorten the lower extremity, tibiocalcaneal arthrodesis using a sandwich block can be performed. We performed tibiocalcaneonavicular arthrodesis using a sandwich block to treat a patient with open talus extrusion caused by a motorcycle accident and obtained good clinical results.

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거골의 외측 돌기와 후방 돌기 내측 결절의 동반 골절(1예 보고) (Concomitant Fracture of Lateral Process and Posteromedial Tubercle of Talus (A Case Report))

  • 안기용;이준영;유재철
    • 대한족부족관절학회지
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    • 제13권2호
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    • pp.233-235
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    • 2009
  • Concomitant fracture of medial tubercle of posterior process and lateral process of the talus has not been reported in Korean literature. Association between fracture of lateral and posterior process of talus is not clear. We treated with open reduction and screw fixation in fracture of lateral process and with excision of fragment of posteromedial tubercle of posterior process with satisfying result.

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거골 골연골병변의 자연 경과 (Natural History of Osteochondral Lesion of the Talus)

  • 경민규;이동오;이동연
    • 대한족부족관절학회지
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    • 제24권2호
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    • pp.37-41
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    • 2020
  • Many articles on operative treatment strategies for osteochondral lesions of the talus (OLT) have been published. On the other hand, there are only a few reports on the conservative treatment of OLT. Understanding the natural history of OLT is essential to establishing the correct treatment. Conservative treatment might lead to comparable clinical outcomes compared to the current options of the operative treatment in isolated OLT lesions. OLT lesions can be divided into two (or possibly three) types. Hence, the prognosis and outcome of certain operative treatments should be evaluated further. The prognosis of OLT combined with instability or malalignment appears poorer than that of isolated OLT lesions. Therefore, concomitant pathologies should be evaluated together when treating patients with OLT.

거골 골연골병변에 대한 수술적 치료: 골수 흡인물 농축액 및 기질 유래 연골 형성 (Operative Treatment for Osteochondral Lesions of the Talus: Bone Marrow Aspirate Concentrate and Matrix-induced Chondrogenesis)

  • 김범수;나엽;권원한
    • 대한족부족관절학회지
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    • 제24권2호
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    • pp.61-68
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    • 2020
  • Bone marrow aspirate concentrate and matrix-induced chondrogenesis (BMIC) is an interesting treatment option for osteochondral lesions of the talus with promising short- to mid-term results. The various terminologies used to describe this surgical method need to be addressed. These include bone marrow-derived cell transplantation, matrix-induced bone marrow aspirate concentrate, and matrix-associated stem cell transplantation. BMIC is a one-stage, minimally invasive surgery performed arthroscopically or using a mini-open arthrotomy approach without a malleolar osteotomy in most cases. The lesion is replaced with hyaline-like cartilage, and treatmentrelated complications are rare. BMIC is a safe and effective treatment option and should be considered in large lesions or lesions with a prior treatment history.

거골의 골연골병변: 자가 골연골 이식술 (Osteochondral Lesions of the Talus: Autologous Osteochondral Transplantation)

  • 배서영
    • 대한족부족관절학회지
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    • 제24권2호
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    • pp.55-60
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    • 2020
  • Among the various surgical treatment methods for osteochondral lesions of the talus, autologous osteochondral transplantation (AOT) is a useful procedure in cases of a large defect, subchondral cyst, and failed primary bone marrow stimulation procedure. Although bone marrow stimulation alone may not regenerate the damaged plate sufficiently, AOT has the advantage of being able to replace the subchondral bone plate and cartilage with a new one at a same time. Nevertheless, postoperative cyst formation or pain may persist and donor site morbidity is still a limitation of AOT.