• Title/Summary/Keyword: 술후 동통

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Clinical Outcomes of the Surgical Excision of the Ganglion Cyst Causing Compressive Neuropathy - A Review of Twelve Collected Cases - (압박 신경병증을 일으킨 결절종의 수술적 절제의 임상적 결과)

  • Jung, Sung-Taek;Cho, Seong-Beom;Moon, Eun-Sun;Lee, Jae-Joon;Kim, Ki-Hyeoung;Yang, Hyun-Kee
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.63-70
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    • 2006
  • Purpose: The purpose of current study was to review the surgical treatment results in patients with a ganglion cyst involving peripheral nerves and to suggest the poor prognostic factor. Materials and Methods: Twelve patients having neurologic symptoms caused by ganglion cyst were treated operatively between 1995 and 2000. The peripheral nerves involved were the tibial nerve in three patients, suprascapular nerve, common peroneal nerve, radial nerve, and ulnar nerve in two patients each, and median nerve in one patient. Pain was present in six patients, sensory disturbance or motor weakness was seen in seven patients each; and sensory disturbance and motor weakness were concurrently present in four patients. Results: In all six patients who complained of preoperative pain, the pain was resolved after surgery. Improvements were seen in five of seven patients who had preoperative sensory disturbance and in all patients who had preoperative motor weakness. Complete sensory recovery was obtained in only two of four patients with preoperative sensory disturbance and motor weakness, indicating a poor prognosis factor. Conclusion: Early accurate diagnosis and early excision of these ganglion cysts causing compression neuropathy could produce excellent clinical results.

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Surgical Treatment of Intramural Hematoma of the Aorta Case Report (대동맥벽내 혈종의 수술치험-증례보고-)

  • 이해원;김관민
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.340-343
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    • 1997
  • We experienced a female patient with intramural hematoma of the aorta. This patient had a severe anterior chest pain radiating to interscapular area with choking sensation. CT revealed a intramural hematoma of the thoracic aorta and a part of the abdominal aorta but there was no evidence of intimal tearing. We did the eme gency operation under hypothermic circulatory arrest and retrograde cerebral perfusion. Ascending aorta was replaced and coronary artery bypass graft was done because of intimal tearing of the ostium of right coronary artery. She was discharged without any significant complication. We reported this case with consideration about necessity of emergency operation for intramural hematoma of the thoracic aorta.

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Clinical trial of Herbal Decoction for Sitz Bath on Postpartum Mother's Perineal Healing (한방좌욕제가 산모의 회음절개술후 동통에 미치는 효과에 대한 임상연구)

  • Kim, Dong-Il;Kwon, Su-Kyung;Jung, Jae-Cheol;Yoon, Sung-Hyeun;Jung, Jae-Joong
    • The Journal of Korean Obstetrics and Gynecology
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    • v.23 no.1
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    • pp.97-107
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    • 2010
  • Purpose: This study was designed to verify the effect of Herbal Decoction for Sitz Bath on postpartum mother's perineal healing. Methods: Women who had given birth vaginally and had an episiotomy were included in study. The primary outcome for study was severity of pain, discomfort, rated on a 10-cm visual analog scale from 0("no pain") to 10("worst pain ever"). As a secondary outcome, we also evaluated side effect and "feeling". Results: In clinical trial, perineal pain, perineal discomfort, after-pain were significantly low at postpartum 3th days, respectively. And mothers were satisfied with "Herbal Decoction for Sitz Bath". Conclusion: According to these results, we finally concluded that "herbal decoction for sitz bath" for perineal care could be effective in healing the perineum.

Discoid Medial Meniscus in the Knee - A case report - (슬관절 내측 원판형 연골 - 1례 보고 -)

  • Kyung, Hee-Soo;Kim, Kyung-Hoon;Oh, Chang-Wug
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.58-62
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    • 2009
  • A discoid medial meniscus is a relatively rare pathology of the knee joint, and we recently encountered a patient with discoid medial meniscus, and this report is a case of therapeutic experience in this patient. The patient was twenty years old man who had a persistent dull pain for several years without specific trauma history. He was presumptively diagnosed as discoid medial meniscus by MRI, and arthroscopic examination confirmed the presence of the complete type of discoid medial meniscus with horizontal tear. We performed arthroscopic partial meniscectomy, and the patient could get free from symptom.

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Arthroscopic Treatment of Synovial Chondromatosis (활액막 연골종증의 관절경적 치료)

  • Bae Dae Kyung;Kwon Oh Soo;Lee Jeong Heui;Lim Chan Teak
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.43-48
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    • 2002
  • Purpose : We evaluated the results of the arthroscopic treatment of nine cases of synovial chondromatosis in the knee joints. Materials and Methods : From June 1989 to September 1999, eight patients nine cases with synovial chondromatosis involving knee joints underwent arthroscopic total synovectomy and removal of loose bodies. There were 6 females and 2 males. The average age at surgery was 44.1 years(range, 20-57 years). The average follow-up period was 5.9 years (range, 2.5-7.3 years). All cases had pain and swelling and two cases had locking preoperatively. Flexion contracture was found in three cases. Results : Pathologic finding revealed Milgram I in one case, Milgram II in six cases and Milgram III in two cases. There were six cases of generalized synovial hypertrophy and one case of localized type. All patients had symptomatic relief by arthroscopic total synovectomy and loose body removal. Second arthoroscopic surgery was performed in one patient due to recurred lesions 11 months after the primary surgery. Conclusion : Clinical results of the synovial chondromatosis with arthroscopic total synovectomy and loose body removal were satisfactory. Arthroscopic total synovectomy was also effective for the recurred case.

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Clinical Results of Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon (슬괵건을 이용한 전방십자인대 재건술의 임상적 결과)

  • Song Eun Kyoo;Lee Keun Bae;Shin Sang Gyoo;Kim Hyun Jong
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.21-25
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    • 2002
  • Purpose: To evaluate the clinical results after anterior cruciate ligament (ACL) reconstruction with hamstring tendon and Ligament Anchor (LA) screw, which is newly designed for fixation of graft into femur. Materials and Methods: Fifty eight patients who were followed up at least more than 2 years after ACL reconstruction with four strands of Hamstring tendon and LA screw were included in this study. The graft was fixed with LA screw at femoral tunnel and with only bioabsorbable interference screw at tibial tunnel. The mean follow-up period was 28 months. The clinical results were evaluated by physical examination and Lysholm knee score. Widening of bony tunnel and anterior laxity difference compared with normal side by instrumented anterior laxity test with Telos(R) (Telos stress device; Austin & Associates, Inc., Polston, US) were evaluated. Results: The Lysholm knee score improved from 60.0 points preoperatively to 94.0 points at last follow up. On the Lachman test, there were mild (+) instability in 16 cases, moderate (++) in 24,severe (+++) in 18 preoperatively. 50 cases were converted to negative and 8 to mild instability at postoperative follow up. On instrumented anterior laxity test with Telos(R), difference between normal and affected knee on 20 lb was 12.9 mm in average preoperatively, and was decreased to 3.1mm at last follow-up. The femoral tunnel was widened from 10.6 mm postoperatively to 12.7 mm (21.1$\%$) at follow up on antero-posterior plane and from 10.7 mm to 12.4 mm (16.5$\%$) on lateral plane. Tibial tunnels was also widened from 9.8mm to 11.8mm (20.7$\%$) on antero-posterior plane and from 9.9mm to 11.7 mm ($18.9\%$) on lateral plane. Complications were: anterior knee crepitus in 17 case, quadriceps muscle atrophy(>3 cm) in 6, penetration of screw over the lateral femoral cortex in 5, saphenous nerve paresthesia in 2.Conclusions: ACL reconstruction with hamstring tendon and LA screw was one of the choice of grafts and fixation devices in restoring knee stability and in improving clinical results with little complications such as excessive widening of bony tunnel and anterior knee pain

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Recycling Bone Autotransplantation with Extracorporeal Heat-Treatment for Malignant Bone Tumors of Pelvis (골반골의 악성 골종양의 재건술에서 체외 열처리를 이용한 재활용 자가골 이식술 및 인공 관절 치환술을 시행한 3례 보고)

  • Kim, Sae-Hoon;Lee, Sang-Hoon;Cho, Hwan-Sung;Kim, Han-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.1
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    • pp.115-123
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    • 2003
  • Study Design: A retrospective clinical and radiographic review. Objectives: The purpose of this study was to suggest recycling bone autotransplantation with extracorporeal heat-treatment as one of favorable reconstruction method for malignant bone tumors of pelvis through 3 cases. Summary of Literature Review: There are many biologic and nonbiologic reconstruction method in pelvic reconstruction. Cases: Case 1- A 20-year-old women had chief complaint of right hip and thigh pain started 3 months ago and done curettage and bone cementing at right ilium at other hospital. She had impression of malignant bone tumor and undergone postoperative radiation therapy for 6 cycles. After that she was referred to our hospital and undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal heat-treatment at 132 degree celsius for 2 minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed well-differentiated osteosarcoma on postoperative pathology. Neither adjuvant nor neoadjuvant chemotherapy were done. Case 2- A 56-year-old women who suffered right thigh pain for 3 months was detected radiologic abnormality at right pelvis. After incisional biopsy, osteosarcoma was diagnosed. We had undergone wide excision of right ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (ABG$^{(R)}$). There was no evidence of distant metastasis and revealed high-grade osteosacoma which was fibroblastic type on postoperative pathology. Adjuvant chemotherapy (HDMTX, ADR, CDDP) was done immediate after wound healing was completed. Case 3- A 46-year-old women was incidently found mass at left ilium which was suspected chondrosarcoma. We had undergone wide excision of left ilium and recycling bone autotransplantation with extracorporeal low heat-treatment at 65 degree celsius for 30minutes internal fixation with pelvic reconstruction plate and total hip replacement arthroplasty (Protek$^{(R)}$). There was no evidence of distant metastasis and revealed chondrosarcoma which was graded II/III on postoperative pathology. Results: Oncologic and functional outcome at final follow-up were for case 1, final follow-up time was 7 years, is no evidence of disease and functional score is 53% according to Ennecking et al. During follow-up, evidence of radiologic union was at about 1 and 6 months after operation. The case had breakage of pelvic reconstruction plate and some resorption of autotransplated bone, but no symptom present. For case 2, final follow-up was 3 years and 6 months, is no evidence of disease and functional score is 60%. For case 3, final follow-up was 7 months, no evidence of disease and functional score is 63% which is improving state. Discussion: 3 cases which were undergone recycling bone autotransplantation with extracorporeal heat-treatment and total hip replacement arthroplasty had relatively successful oncologic and functional outcome. Taking account that difficulty in using allograft in Korea this method is thoght to be one of the useful way to reconstruct pelvis after resection of primary malignant bone tumor of the pelvis.

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Postoperative Complications After Arthroscopic Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft (자가 슬개건을 이용한 전방 십자 인대 재건술의 수술 후 합병증)

  • Zhu, Fang Zhen;Yoo, Moon-Jib;Kim, Myung-Ho;Park, Hee-Gon;Bahng, Seung-Chul
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.7 no.2
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    • pp.122-127
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    • 2008
  • Purpose: Evaluation and analysis of the incidence of postoperative complications after arthroscopic anterior cruciate ligament reconstruction using bone-patellar tendon-bone autograft. Materials and Methods: We reviewed 172 cases of arthroscopic anterior cruciate ligament reconstruction using bone-patellar tendon-bone autograft in anterior cruciate ligament tear without meniscal injury. We performed Lysholm knee score and KT-2000 testing, simple radiograph, physical examination as evaluation factor. Also, around knee pain, swelling, limitation of motion, patellofemoral crepitation, paresthesia and pain on kneeling were evaluated. Results: The average follow up period was 49.8 months. In 172 patients, 148 males and 26 femlaes were evaluated. The average age was 34.4 years. The Lysholm knee score improved from 51.9 points preoperatively to 90.8 points at final follow up. Clinical outcome was excellent in 83%, good in 11%, fair in 4% and poor in 2%. There were many cases of complications, 24 cases (14%) of around knee pain, 12 cases (7%) of swelling, 45 cases (26.2%) of patellofemoral crepitation, 52 cases (30%) of donor site paresthesia, 65 cases (38%) of pain on kneeling, 10 cases (5.8%) of limitation of motion at extension, 13 cases (8%) of limitation of motion at flexion and 2cases (1.2%) of patellar fracture. Conclusion: Although arthroscopic anterior cruciate ligament reconstruction using bone-patellar tendon-bone had good clinical results, many complications were noted. Some factors in surgical technique were suspected to be related to the complications and long term follow up will be necessary to further evaluated.

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Suprascapular Nerve Entrapment Syndrome Caused by Ganglion (결절종에 의한 견갑상신경 포착 증후군)

  • Kim Soung Yon;An Sung Chan;Chun Jae Myeung
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.1 no.1
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    • pp.65-70
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    • 2002
  • Purpose : To review the operative results and find out better method of a treatment of suprascapular nerve entrapment syndrome caused by ganglion. Materials and Methods : From March of 1996 to May of 2001, thirteen cases of suprascapular nerve entrapment syndrome caused by ganglion were reviewed which were diagnosed using physical examination, EMG and MRI. All of them were treated with open exision of ganglion, nerve decompression and arthroscopic examination. The clinical results were evaluated using subjective recovery of muscle power and ASES (American Shoulder and Elbow Surgeons) score. Results : Nine cases (69$\%$) showed residual symptom such as intermittent pain, insufficient recovery of muscle power, persistent muscle atrophy. Complete recovery in four cases (31$\%$). Mean value of ASES score was 86.4 (70-99.8) points. Postopertively, pain was relieved in 84$\%$ of patients and muscle power was improved in 53$\%$ of the patients but the atrophy persisted. Conclusions : Excision of ganglion is insuffient to relieve the nerve entrapment. Not only excision of ganglion but also treatment of intraarticular lesion, decompression of suprascapular and spinoglenoid notch which attributable to entrapment should be considered for the better clinical results.

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Arthroscopic Versus Open ACJJ'omioplasty for Impingement Syndrome and Partial Thickness Rotator Cuff Tear (충돌증후군 및 회전근개부분좌열에서의 관절경적 견봉성형술과 개방적 견봉성형술의 비교 분석)

  • Rhee Yong-Gir;Chang Ki-Seong
    • Clinics in Shoulder and Elbow
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    • v.1 no.1
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    • pp.109-117
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    • 1998
  • We evaluated the results of the surgery for impingement syndromes and partial thickness tears of the rotator cuff with an average follow-up period of 15 months. One group(group I) of 43 patients, 46 cases underwent arthroscopic subacromial decompression. The other comparable group(group Ⅱ) of 10 patients, II cases underwent open acromioplasty. The average age at operation was 48 years, old. Arthroscopic subacromial decompression achieved slightly better pain relief, the range of the acti ve forward flexion, function, strength and the overall score with improvement from the preoperative condition than open acromioplasty. The patient's satisfaction was better in group I as well. Using the UCLA Shoulder Rating Scale, 89% of group I and 82% of group n had good or excellent results. Preservation of the origin of the deltoid during an arthroscopic acromioplasty reduced the postoperative morbidity and made it possible to start rehabilitation sooner and to achieve the better and more predictable results.

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