• Title/Summary/Keyword: 내시경적 봉합술

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Arthroscopic Meniscal Repair with Rapid Loc Device (Rapid Loc 기기를 이용한 관절경적 반월상 연골판 봉합술)

  • Kwon, Duck-Joo;Lee, Kee-Byung;Joeng, Woong-Kyo;Lee, Byung-Taek;Park, Sang-Wook
    • Journal of the Korean Arthroscopy Society
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    • v.9 no.2
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    • pp.180-185
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    • 2005
  • Purpose: To purpose of this study is to evaluate the clinical and radiological results of arthroscopic meniscus repair using Rapid Loc device. Materials and Methods: A retrospective study was performed on 44 cases which had been turned out longitudinal tear without degeneration. We repaired all cases with Rapid Loc device. Patients were evaluated using clinical examination, Orthopaedische Arbeitsgemeinschaft Knie (OAK) scheme, and MRI. We regarded patients with joint line tenderness, swelling or McMurray positive test as clinical failure. Results: A mean age was 33.3 years and follow-up period was average 15 months. Clinical results were excellent 15 cases(34.1%), good 20 cases(45.5%), fair 7 cases(15.9%), poor 2 cases(4.5%). MRI showed grade 115 cases(33.3%), grade II 22 cases(50%), grade III 7 cases(16.7%). Clinical failures were 8 cases and only one complication was developed. Conclusion: Rapid Loc device showed the excellent results in meniscus repair. We regard it has a lot of advantages in safety, softness, ease, ability to control tension at repair site.

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Aorto-Esophageal Fistula Complicated by Esophageal Metalic Stent -A case report- (식도 내 금속 스텐트 삽입 후 발생한 대동맥 식도 누공 -치험 1례-)

  • 윤영철;조광현;김기봉;전희재;최강주;이양행;황윤호
    • Journal of Chest Surgery
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    • v.35 no.6
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    • pp.479-482
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    • 2002
  • Aortoesophageal fistula induced by endoesophageal stent is rare; however, it is usually a fatal disorder, with few survivors reported. We report a case of a 32-year old female with aortoesophageal fistula after insertion of the esophageal stent in esophageal lye stricture who was successfully diagnosed with endoscopy and treated in a two-stage operation. In the first stage, we performed esophagectomy, primary repair of the fistula site in the descending thoracic aorta, and feeding gastrostomy. After the patient recovered well postoperatively, a retrosternal interposition of the right colon and cervical esophago-colo-grastostomy were performed, to re-establish the gastrointestinal tract.

Shoulder instability with congenital absence of bilateral long head of biceps tendon - A Case Report - (양측성 상완이두장건 결손과 견관절 불안정성 - 증례 보고 -)

  • Rah, Jung-Ho;Chung, Hoi-Jeong;Kim, Doo-Sup
    • Journal of the Korean Arthroscopy Society
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    • v.14 no.3
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    • pp.188-191
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    • 2010
  • Absence of long head of biceps tendon is a very rare anomaly. We encountered a 19 year-old male patient who had right shoulder subluxation. On magnetic resonance imaging, shallow intertubercular groove on right humerus was observed, and absence of long head of biceps tendon was discovered. Arthroscopically, labral rupture and absence of long head of biceps tendon were also evident. Left shoulder had a similar symptom as right 5 months after the initial development of the symptom on the right shoulder. Both MRI and arthroscopy revealed absence of long head of biceps tendon and labral ruptre. Arthroscopic labral repair was performed for both shoulders, and, postoperatively, they were fixated with abduction brace. In this case, it is considered that the absence of long head of biceps tendon triggered the instability of shoulder found in our patient.

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Clinical and Arthroscopic Findings of Medial Meniscus Posterior Horn Insertion Tear (내측 반월상 연골판 후각 기시부 파열의 특징 및 관절경 소견)

  • Lee, Jun-Young;Kim, Dong-Hui;Ha, Sang-Ho;Lee, Sang-Hong;Gang, Joung-Hun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.8 no.1
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    • pp.33-38
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    • 2009
  • Purpose: We wanted to report the clinical characteristics and arthroscopic findings of radial tear in medial meniscus posterior horn insertion, commonly occurs in patient over middle age with documentary review. Materials and Methods: Retrograde study using hospital records was done to 40 cases in 40 patients who visited our hospital and had been performed knee arthroscopic surgery due to medial meniscus posterior horn insertion tear between January, 2005 to April, 2007. Seven cases were male and 33 cases were female with the mean age of 61 (range, 47-80). Trauma history, stage of arthritis, period between pain and operation, MRI findings, clinical symptoms and operation methods were evaluated. Results : Six cases had trauma history while 34 cases didn't. In simple x-ray, using Kellgren-Lawrence classification, 31 cases were between stage 0 and II while 9 cases were stage III. In arthroscopic exam, there were 17 cases of Outerbridge grade IV, 4 cases of grade III, 9 cases of grade II, 9 cases of grade I. The mean duration of pain was 5.3 months. In MRI, at least one finding of cleft in axial or coronal view or ghost sign in sagittal view was found in all cases. The shape of meniscus tears were blunt in 18 cases, transverse in 12 and degenerative tear in 10. Subtotal meniscectomy was performed in 16 cases, partial meniscectomy in 10 cases and meniscal repair in 14 cases. Conclusion : Medial meniscus posterior horn insertion tear occurs in patients over middle age is rarely related to trauma history but causes painful mechanical symptom and usually accompany arthritis. Meniscectomy can be done for the treatment but repair can be considered is some cases. Further study on the treatment result will be needed.

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New Technique for the Reconstruction of Both Anteromedial & Posterolateral Bundles of ACL (전방십자인대의 전내측 다발 및 후외측 다발을 각각 재건하는 새로운 수술 수기)

  • Ha Chul-Won;Awe Soo-Ik
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.195-199
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    • 2002
  • This article is to report a new technique for reconstruction of the anteromedial and posterolateral bundles of anterior cruciate ligament by separate tensioning and fixation of the each bundle. Method : Tibial and femoral tunnels were made with conventional technique of anterior cruciate ligament reconstruction. Tibial tunnel was enlarged $5\~7$ mm in anterior-posterior direction to make oval it in cross section. When preparing the Achilles tendon allograft, bone plug portion was trimmed as the conventional technique. The tendinous portion was trimmed as two separate bundles by dividing the tendinous portion longitudinally, so the graft is shaped like 'Y'. The bone plug portion of allograft was inserted into the femoral tunnel and fixed with absorbable cross pins. Two ligamentous portionss of the distal part of the grafts were tensioned separately at the external orifice. Anteromedial bundle was fastened under maximum tension with the knee flexed 90 degrees by post-tie method. The posterolateral bundle was fixed by the same technique with the knee in full extension. Then, an absorbable interference screw was inserted between the two bundles upto the upper end of the tibial tunnel, to get more initial rigidity of the reconstructed graft as well as to locate the two bundles in more anatomic position.

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