• Title/Summary/Keyword: 고관절 수술

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Synovial Chondroma Causing Radial Nerve Palsy (요골 신경 마비를 유발한 활액막 연골종)

  • Chun, Young-Soo;Kim, Joon-Yong
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.1
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    • pp.55-59
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    • 2007
  • Synovial chondroma is an uncommon benign lesion characterized by metaplastic cartilage formation within the synovial connective tissue, usually intraarticular, commonly affects the knee, hip and elbow. We would like to present the case of a 65-year-old man suffering from synovial chondroma of the right elbow responsible for radial nerve entrapment neuropathy. This is a case of synovial chondroma of the right elbow in an 65-year-old man presenting with pain and restricted joint movement of the right elbow, loss of extension and sensation of the right thumb and wrist. Plain radiographs showed narrowing of elbow joint space, bony spur on the edge of the joint, and radio-opaque sclerotic change of subchondral area. MRI revealed $16{\times}12$ mm sized round mass on the radial head, homogenous low signal on T1WI, heterogenous high and low signal on T2WI. The patient underwent marginal excision of the mass, compressing the radial nerve. Diagnosis was confirmed by histologic examination.

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Wear and Implantation Tilt Measurements using X-ray and CAD (X-ray영상과 CAD를 이용한 인공고관절의 마모 및 식립각 측정법)

  • Lee, Jong Min;Lee, Yeon Soo
    • Journal of the Korean Society of Radiology
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    • v.12 no.1
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    • pp.107-114
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    • 2018
  • Long-term complications such as loosening, wear, osteolytic lesion and granulomatous reaction by foreign bodies can occur, after total hip arthroplasty. The implantation alignment effects dislocation and wear, according to its amount and direction. Wear particles in total hip arthroplasty brings about biochemical complications such as osteolysis or send wear. In this sense, it is important to regularly check wear and alignment of total hip replacement. Because the wear in followup of 10 years may remain in a small amount, like a 1 or 2 mm generally, somewhat precise measurement tool has to be established. The wear and alignment measurement softwares commercially available currently lack in project saving or reproducibility. This study suggests a reliable method for the measurement using an X-ray image and a CAD software. The proposed method can be executed only if having a CAD software under most of current general clinical radiographical environment. The proposed was revealed through tests for the method to have accuracy of 0.06 mm with precision of 0.05 mm for wear measurement, and precision of 0.27 degrees for tilt measurement.

Effect of a decreased activity following THRA on circumference, volume and strength of normal and operated lower extremities (고관절 전치환술(Total Hip Replacement Arthroplasty) 환자의 수술후 활동저하가 하지근 위축에 미치는 영향)

  • 채영란;최명애
    • Journal of Korean Academy of Nursing
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    • v.24 no.1
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    • pp.115-128
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    • 1994
  • The purpose of this study was to observe the change of circumference, volume and strength of normal and operated lower extremities on 3rd, 7th, 10th, and 14th days of postoperation following THRA compared with their condition on preoperation day. Subjects consisted of 13 male and 7 female Patients operated with THRA between the age of 20 and 69 years with a mean age of 38.55(SD=15.1). Circumference of upper and lower leg was measured by tape, leg volume was determined according to formula (Moor & Thornton, 1987) with measurement of 8 circumferences of leg. Leg strength was measured by pressing the center of digital health meter in supine position. The results can be summarized as follows : 1. Circumference of operated thigh decreased significantly at 14 following THRA compared with preoperative value, while that of normal thigh decreased significantly at day 3, 7, 10 and 14 after THRA compared with preoperative value. 2. Circumference of midcalf in both operated and normal limb decreased significantly at day 3, 7, 10 and 14 following THRA compared with preoperative value. 3. Leg volume of operated lower limb decreased significantly at 10, 14 following THRA compared with preoperative value, while that of normal limb decreased significantly at day 7 & 10 after THRA compared with preoperative value.4. Leg strength of operated limb decreased significantly at day 3, 7, 10, 14 following THRA compared with preoperative value. No significant difference of normal leg strength was shown following THRA. 5. Circumference of midcalf differed significantly at day 14 after THRA between normal and operated extremity. From these results, it can be suggested that a decreased activity after THRA caused muscle atrophies in normal and operated extremity.

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Incidence and Associated Factors of Delirium after Orthopedic Surgery (정형외과 수술 후 발생한 섬망의 발생 빈도와 관련 인자)

  • Lee, Si-Wook;Cho, Chul-Hyun;Bae, Ki-Cheor;Lee, Kyung-Jae;Son, Eun-Seok;Um, Sang-Hyun
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.157-163
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    • 2019
  • Purpose: To investigate the incidence and associated factors of delirium after orthopedic surgery. Materials and Methods: A total of 2,122 cases, who were older than 20 years and underwent orthopedic surgery at a single medical center during a one year period were included. Among them, 132 patients who were diagnosed with delirium after surgery under the Diagnostic and Statistical Manual of Mental Disorders-V criteria and medicated under the consultation of a psychiatrist were included in the study The differences in the incidence of delirium and several affecting factors were analyzed. Results: The overall incidence of delirium after surgery was 6.2% (132 in 2,122 cases). The mean age of the delirium group was 77.4 years (range, 54-92 years), which was higher than that of the non-delirium group (58.1 years). The percentage of women in the delirium group was 63.6% (84 in 132 cases), which was higher than that of the women in the non-delirium group (49.0%). The incidence of delirium after surgery was 9.3% (85 in 916 cases) due to trauma and 3.9% (47 in 1206 cases) due to disease. The incidence of postoperative delirium according to the surgical region was 29.2% (7 in 24 cases) in two or more regions, 13.7% (72 in 526 cases) in the hip, and 9.6% (14 in 146 cases) in the spine, 3.5% (20 in 577 cases) in the knee-lower leg, 2.5% (5 in 199 cases) in the foot-ankle, 2.4% (11 in 457 cases) in the shoulder-elbow, and 1.6% (3 in 189 cases) in the forearm-wrist-hand. Delirium occurred more rapidly in women and surgery due to disease, and the duration of delirium was longer in patients with dementia and major depressive disorders. Conclusion: The incidence of postoperative delirium was high in cases of surgery due to trauma and in cases of surgery in two or more sites. The incidence of postoperative delirium according to a single surgical region was higher in the order of the hip, spine, and knee. Active intervention is needed regarding the correctable risk factor.

A Case Study of Physical Therapy for Developmental Dysplasia or Dislocation of the Hip After Operation (발달성 고관절 이형성증 또는 탈구 환자의 수술후 물리치료)

  • Park, So-Yon
    • Physical Therapy Korea
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    • v.6 no.2
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    • pp.77-86
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    • 1999
  • Developmental dysplasia or dislocation of the hip is the most pronounced form of a condition in which the femoral heads tends progressively to leave the acetabulum. In the young child the variability of findings and course suggest a spectrum of conditions in which there are a number of common features: restriction of movement, particularly of abduction in flexion; shortening; and abnormal radiology, including a sloping or dysplastic acetabulum and delay in the appearance of the upper femoral epiphysis. It is vital to make the diagnosis of a congenital dislocation as soon after birth as possible. Conservative treatment with an abduction brace before the child run begins to walk is completely adequate, but after the age of 4 even surgical repositioning is difficult and after the age of 7 it is almost impossible. The aim of the study was to gain insight into the value of physical therapy of developmental dysplasia or dislocation after operation.

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Design and Control of a Master/Slave Combined Surgical Robot for Total Hip Replacement Surgery (Master/Slave 복합형 고관절 전치환 수술 로봇의 설계와 제어)

  • 권동수;허관희;정종하;박영배;이정주;원중희;윤용산
    • 제어로봇시스템학회:학술대회논문집
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    • 2000.10a
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    • pp.540-540
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    • 2000
  • This paper explores design and control methods of a surgical robot for total hip replacement surgery which can be easily maneuvered by a surgeon Like an advanced surgical tool. The 3-DOF in-parallel surgical robot is fixed directly onto patient's femur by the bone clamp during surgery. With the master/slave combined surgical robot, the surgeon can directly control the motion of the surgical robot with surgeon's experience and judgment during operation. For the easiness of operation, the master/slave combined robot is controlled using admittance control paradigm. And for the precise operation, the robot motion is restricted at the surgical boundary using virtual hard wall display.

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Tumor Resection and Reconstruction in Periacetabular Single Metastases of Renal Cell Carcinoma - A Case Report - (신장 암의 비구주위 단독 전이 환자에서 종양절제 및 재건술 - 증례 보고 -)

  • Shin, Duk-Seop;Han, Dong-Sung
    • The Journal of the Korean bone and joint tumor society
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    • v.13 no.2
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    • pp.113-118
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    • 2007
  • Surgical treatment of pelvic bone tumors represent one of the most complicated problem in musculoskeletal oncology. Because of three dimensional anatomy of the pelvis, tumors reach huge sizes and the diagnosed late relatively to a similar tumors in extremity. Especially, there are limited reconstruction methods to keep the function of hip joint after resection of periacetabular tumors, and the results of reconstruction is not so promissing. We present one case of periacetabular metastatic tumor from renal cell carcinoma, which was resected with wide margin and reconstructed with composite of pasteurized autogenous bone graft and constrained total hip arthroplasty.

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A Case Study of lower Extremity Amputation Patient (하지 절단 환자의 간호 사례 연구)

  • Cho M O
    • The Korean Nurse
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    • v.23 no.3 s.126
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    • pp.68-76
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    • 1984
  • 본 환자를 간호하면서 절단으로 인해 신체적 고통을 받고 있는 존재로서, 생각과 정서, 욕구를 지닌 존재로서의 환자를 돕고자 시도해 보았다. 신체적인 적응을 돕기 위해서 근력강화와 관절가동역증진, 통증조절, 보조기 착용을 위한 단단의 관리, 잔여관절의 변형예방에 중점을 두었다. 심리적인 적응을 돕기 위해서 환자가 절단 수술과 수술 후 변화된 신체외모를 수용하는 과정을 증시했다. 끝으로 사회적인 면에서는 의미있는 사람들의 집단속에서 존재하는 인간으로서의 환자에게 관심을 두었다. 환자의 우측 슬관절 가동역은 완전히 회복된 상태는 아니지만 목발을 이용하여 걷거나 기타 일상생활을 하는데 불편함은 없으며 앞으로 계속적인 노력을 통해 회복될 수 있을 것이다. 그의 좌측 고관절 가동역은 정상유지되고 있으며 절단부위는 보조기 착용에 적합하게 형성되어 가고 있다. 비슷한 처지에 있는 이씨환자의 도움과 환자의 독립적인 생활태도는 환자가 자신의 불구에 적응하고 일상생활에 적응하는데 많은 도움이 되었다. 협조적이고 동정적인 환자들과 의료진의 도움으로 환자는 보호된 병원환경내에서 신체적 제한점을 주목하고 자신의 불구에 적응하면서 타인들과 원만한 관계를 유지해 왔다. 그는 앞으로 사회에 돌아가서 생활하게 될 것이다. 우리 사회는 아직도 그들에 대해 편견을 가지고 있으며 직업적 교육적 의료치료적 배려가 부족한 상태이다. 사회속에서의 적응은 병원에서의 적응보다 훨씬 더 어려울 것이며 때로는 그를 좌절하게 할 것이다. 그의 신체적 결함이 자기 자신만의 책임은 아니며 어느 누구나 사고에 희생될 가능성은 있다. 사회인들이 그들에게 관심있고 수용적인 태도를 지니고 그들의 정상 요구와 인간으로서 동등하게 살아갈 권리를 인정하고 받아들인다며 좀더 쉽게 자신의 슬픔을 극복할 수 있을 것이다.

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Percutaneous Radiofrequency Therapy of Benign Bone Tumors in the Femoral Head (대퇴골두 부위에 발생한 양성 골 종양에 대한 경피적 고주파치료 (증례보고))

  • Seo, Jai-Gon;Kim, Eung-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.84-92
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    • 2003
  • Purpose: To report two cases of bone tumors other than osteoid osteoma in the proximal femur and treated with percutaneous high frequency radioablation method. Cases: We reviewed two cases with intracortical chondroma and enchondroma in the femoral head retrospectively. The patient with intracortical chondroma was a thirty one year old woman and had suffered right hip pain of 1 year duration. The lesion was located in the head of right femur and treated with CT guided percutaneous high frequency radioablation after needle biopsy under general anesthesia. The symptom was gone immediately after the procedure and was discharged postop. 1 day. 15 months has passed without symptom recurrence. Second case having enchondroma, was 56 year old woman complaining of gluteal area pain for 3 months. Radiologic evaluation showed osteolytic lesion with sclerotic rim on the inferior portion of the left femoral head. She received a same therapy with CT guided radiofrequency ablation following needle biopsy. She reported dramatic pain relief after the procedure and was discharged postop. 1 day. No symptom has occurred for 3 months until now. Conclusion: We present 2 cases of bone tumor occurred in the hip joint area other than osteoid osteoma which were treated with CT guided radiofrequency ablation.

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Pigmented Villonodular Synovitis Mimiking the Bone Tumor of the Fossa Olecrani of Elbow in a 8-year-old Boy - A Case Report - (8세 남아에서 골종양을 닮은 주관절 색소 융모 결절성 활액막염 - 증례 보고 -)

  • Kim, Sung-Soo;Lee, Sang-Yup;Yoon, Min Geun;Seo, Young Hoon;Moon, Myung-Sang
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.138-142
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    • 2012
  • Pigmented villonodular synovitis (PVNS) is a rare benign proliferative disorder that results in villous hyperplasia and nodule formation in the synovium, tendon sheath and bursa. That most commonly affects the knee and the hip joint in adult. PVNS of the hand, the wrist, the shoulder and the elbow is rare and that of the elbow in children is particularly rarer. An eight-year-old boy had his left elbow pain and a lesion like benign bone tumor in the left fossa olecrani on plain x-ray. During the operation, abnormal synovial hyperplasia in his left elbow joint led us to diagnose PVNS. Therefore, open curettage of the lesion and radical synovectomy was performed. The specimen of the synovectomized tissue revealed PVNS. The left elbow pain subsided after the operation and the child restored a full range of motion of his left elbow. We reported this rare case of PVNS in a child's elbow joint mimicking the bone tumor together with a review of the literature.