• Title/Summary/Keyword: 내고정술

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Arthroscopic Ankle Fusion (관절경적 족관절 고정술)

  • Kim, Hak-Jun
    • 대한관절경학회:학술대회논문집
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    • 2009.10a
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    • pp.93-98
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    • 2009
  • 족관절 고정술은 족관절에 발생한 심한 관절염(end-stage arthritis)에서 전통적으로 시행하던 술식으로 현재 사용되고 있는 인공 족관절 치환술이 발달되기 전까지는 gold standard 로 알려져 있었으며 현재에도 심한 족관절의 변형이나 파괴, 족관절 인공 관절의 실패시에 시행되고 있다. 1897년 Albert가 처음으로 족관절 고정술을 소개한 이후로 30여가지가 넘는 방법이 행해지고 있으나 개방적 관절 고정술의 단점인 수술 후 염증, 유합 지연, 연부조직의 손상에 의한 피부 괴사 등을 극복하고 유합물을 높이기 위해 다양한 내고정 및 외고정 장치를 사용하고 있다. 관절경 술식이 발달하면서 Schnider가 1983년 최초로 관절경을 이용한 족관절 고정술을 발표한 이후로 관절경하의 족관절 고정술은 개방적 족관절 고정술 보다 높은 유합율과 적은 수술 합병증으로 인해 관심의 대상이 되었지만 족관절의 변형이 심한 경우에는 시행하기 어려운 단점이 있는 것으로 알려져 왔다.

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Arthrodesis of the Knee Using a Retrograde Femoral Intramedullary Nail: Technical Report (역행성 대퇴부 골수강 내 금속정을 이용한 슬관절 고정술: 술기 보고)

  • Wang, Lih;Kim, Sun Hyo
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.183-189
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    • 2021
  • Arthrodesis is one of the last options available to obtain a stable, painless knee in patients who are unable to undergo reconstructive surgery due to a damaged knee joint. A variety of techniques have been used, including external fixation, internal fixation by compression plates, intramedullary fixation through the knee with a modular nail, and antegrade nailing through the piriformis fossa. Another option is the use of a short nail such as the Neff nail, the Wichita nail, or the Huckstep nail, but there are no commercial short nails available for use in Korea. This technical report describes a technique for knee arthrodesis using a retrograde femoral intramedullary nail.

금속판을 이용한 구상돌기 골절의 치료

  • Sin, Dong-Ju;Byeon, Yeong-Su;Jo, Yeong-Ho;Park, Ho-Won;Yun, Hui-Min;Han, Jae-Hwi
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2009.03a
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    • pp.130-130
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    • 2009
  • 불안정한 주관절이 동반된 전위된 구상돌기 골절들을 내측 접근법을 통한 금속판 고정으로 안정된 고정과 만족스러운 골유합을 얻을 수 있었다.

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Hill-Sachs 병변을 동반한 재발된 외상성 견관절 불안정성에서 'Remplissage' 술기를 이용한 관절경적 술식 - 증례 보고 -

  • Go, Sang-Hun
    • The Academic Congress of Korean Shoulder and Elbow Society
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    • 2009.03a
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    • pp.185-185
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    • 2009
  • 관절와 및 상완골의 의미 있는 골결손을 동반한 불안정한 견관절에 대해 어떻게 최선의 치료를 할 것인가에 대한 의문은 남아있다. 어떤 저자들은 외회전과 외전을 제한하는 것으로 Hill-Sachs 병변의 진입을 예방하는 일종의 관혈적 관절낭 변위를 통한 제한된 상완와관절 운동을 주장해왔으며, 다른 관혈적 시술들은 극하근건과 관절낭을 Hill-Sachs 병변 내로 관혈적 전이시키는 것으로 기술되어왔다. 최근에는 여러 저자들에 의해 Hill-Sachs 병변의 진입을 치료하는 더 새로운 접근법들이 기술되었으며, Bankart 병변 복원술에 더하여 Hill-Sachs 병변을 채우기 위해 관절경 하 후방 관절낭 고정술과 극하근건 고정술로 이루어진 이른바 'Remplissage'술기가 소개된 바 있어, 이에 저자는 외상성 견관절 불안정성으로 관절경 하 Bankart 병변 복원술 및 관절낭 축화술 시행 후 외상으로 재발된 견관절 불안정성이 발생하여 관절경 하 Bankart 병변 복원술과 함께'Remplissage'술기를 이용한 Hill-Sachs 병변 복원술을 시행한 예를 보고하는 바이다.

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Arthroscopy Assisted Percutaneous Reduction and Screw Fixation of a Displaced Intra-articular Glenoid Fracture - A Case Report - (유경나사를 이용한 견갑골 관절와 골절의 관절경적 정복 및 내고정 - 증례 보고 -)

  • Ko, Sang-Hun;Jeon, Hyung-Min;Shin, Seung-Myeong
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.127-131
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    • 2010
  • Purpose: The authors used arthroscopy-assisted percutaneous reduction and cannulated screw fixation rather? than conventional arthrotomy for displaced glenoid fracture. Materials and Methods: We used arthroscopy assisted reduction and screw fixation for a 66 year old man who had a clavicle fracture, a displaced glenoid fracture and a scapula fracture. Results: At 9 months postoperatively, the patient had recovered full range of motion and was not inconvenienced by the surgery. Removal of the implant was done 12 months post-operatively under general anesthesia. Conclusion: The advantages of arthroscopy-assisted percutaneous screw fixation are less pain and less bleeding, shorter hospital stay and earlier rehabilitation. Arthroscopic percutaneous screw fixation for a displaced glenoid fracture seems to be a good alternative treatment method.

Comparative Analysis of Fracture Angulation between Parallel Pinning and Plate Fixation Techniques in the Management of 5th Metacarpal Fractures (제 5 수지 중수골 골절에서 평행 핀 또는 플레이트 고정술 이후 골절각 변화에 대한 비교 연구)

  • Lee, Myungchul;Shin, Hyojung;Choi, Hyungon;Kim, Jeenam;Shin, Donghyeok
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.230-238
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    • 2018
  • Purpose: Metacarpal fractures are common injuries of the hand. They are treated using closed reduction (CR) or open reduction (OR) techniques. The management strategy depends on fracture site characteristic and fixation methods. In this study, we evaluated pre- and postoperative fracture angulation, when metacarpal fractures bad been treated using two different techniques: CR with parallel transverse pinning and OR with plate fixation. Methods: Forty-six patients undergoing anatomic reduction to treat extra-articular metacarpal fractures were recruited. They were included in one of two therapeutic groups: Group 1, CR with parallel transverse pinning (n=21); Group 2, OR with plate fixation (n=25). Fracture angulation values have been measured on pre- and postoperative radiologic images. Values were compared between pre- and postoperative states, and between corresponding measurements of each group. Results: All extra-articular metacarpal fractures were successfully treated without wound related complications or the limit of joint motion. Both groups demonstrated adequate reduction at immediate postoperative period (postoperative angulation of group 1, $20^{\circ}{\pm}7^{\circ}$; group 2, $19^{\circ}{\pm}5^{\circ}$). During the observation at follow-up period, Group 1 exhibited slight recurrence (follow-up angulation of group 1, $24^{\circ}{\pm}10^{\circ}$). Nonetheless, Group 2 showed adequate reduction state in both immediate postoperative and long-term follow-up periods (follow-up angulation of group 2, $18^{\circ}{\pm}6^{\circ}$). Conclusion: Extra-articular metacarpal fractures were successfully restored without functional complications. CR with parallel transverse pinning method exhibited recurrence after pin removal, which necessitates cautious postoperative exercise and monitoring.

Repair of Bilateral Perineal Hernia with Semitendinosus Muscle Transposition Along with Colopexy and Cystopexy in a Bitch (암컷 개의 양측 회음 허니아에서 결장 고정술과 방광 고정술 후 반힘줄 근육 전위술의 이용)

  • Heo, Su Young;Lee, Dong Bin;Lee, Hae Beom
    • Journal of Veterinary Clinics
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    • v.30 no.5
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    • pp.371-375
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    • 2013
  • An 11 year-old intact female Yorkshire Terrier weighing 3.5 kg was presented with the complain of having a perineal mass, fecal incontinence and tenesmus. Physical examination revealed reducible bilateral ventral perineal mass, enlarged mammary gland and vaginal discharge. Bilateral ventral perineal hernia (BVPH) and pyometra were diagnosed based on the clinical and radiographic findings. Ovariohysterectomy was performed after general anaesthesia to treat pyometra. The BVPH was repaired by herniorrhaphy with semitendinosus muscle transposition along with colopexy and cystopexy. The postoperative radiographs and CT revealed a good correction of the BVPH. The patient showed good activity after 10 days and no complications were observed during a one year follow up period. BVPH can be successfully surgically managed by herniorrhaphy with semitendinosus muscle transposition along with cystopexy and colopexy in the dog.

Treatment of Distal Tibial Spiral Fractures Combined with Posterior Malleolar Fractures (후과 골절이 동반된 경골 원위부 나선상 골절의 치료)

  • Kim, Young Sung;Lee, Ho Min;Kim, Jong Pil;Chung, Phil Hyun;Park, Soon Young
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.4
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    • pp.317-325
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    • 2021
  • Purpose: This study compared the functional and radiologic outcomes of intramedullary nailing (IMN) and minimally invasive plate osteosynthesis (MIPO) for tibia fractures in distal tibial spiral fractures combined with posterior malleolar fractures, as well as the functional and radiologic outcomes with and without fixation for posterior malleolar fractures. Materials and Methods: From January 2010 to December 2018 the radiological and clinical outcomes of 30 skeletally mature patients with tibial spiral fractures (AO Foundation/Orthopaedic Trauma Association classification 42-A1, B1, C1) combined with posterior malleolar fractures were analyzed. Sixteen patients were treated with IMN, and 14 patients were treated with MIPO. Depending on the surgical methods, the radiologic and clinical outcomes were compared by evaluating the bone union time, postoperative alignment, postoperative displacement of the posterior malleolar fragment, and American Orthopaedic Foot and Ankle Society (AOFAS) score. Moreover, the functional and clinical outcomes with and without fixation for posterior malleolar fractures were compared. Results: The mean bone union time was 21.8 weeks in the IMN group and 23.1 weeks in the MIPO group (p=0.500). At the final follow up, the mean alignment was coronal angulation of 1.8°, sagittal angulation of 1.6° in the IMN group and coronal angulation of 1.2° and sagittal angulation of 1.7° in the MIPO group (conoral angulation: p=0.131, sagittal angulation: p=0.850). The postoperative and final radiologic evaluation showed no displacement of the posterior malleolar fragment and excellent joint congruity in all cases. At the final follow-up, the mean AOFAS score was 88.0 on average in the IMN group and 87.6 on average in the MIPO group (p=0.905). The ankle range of motion and AOFAS score were similar in the fixation group and no fixation group for posterior malleolar fractures. Conclusion: Both IMN and MIPO for tibial spiral fractures combined with posterior malleolar fractures result in satisfactory radiological and clinical outcomes.

Dual Plate Fixation for Displaced Transverse Fracture of the Lower Sacrum (전위된 하부 천골 횡골절에 대한 이중 금속판을 이용한 내고정술)

  • Choi, Dong-Hyuk;Park, Ji-Hun;Shim, Seong-Woo;Choi, Yong-Soo
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.178-182
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    • 2020
  • Isolated fractures of lower sacrum are commonly treated conservatively in most cases because of low energy damage and stable fracture. However, surgical treatment is required in displaced unstable fracture. But the surgical technique is not established and even case reports are not common. We reported a case of displaced transverse fracture of the lower sacrum that was treated with an open reduction and dual plate fixation.