• 제목/요약/키워드: 인대

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항법장치를 이용한 골종양 수술 (Computer-Assisted Orthopaedic Surgery in Bone Tumor)

  • 조환성;박일형;문종욱;김한수
    • 대한골관절종양학회지
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    • 제15권1호
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    • pp.1-6
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    • 2009
  • 컴퓨터를 이용한 정형외과 수술(Computer-assisted orthopaedic surgery, CAOS) 분야는 인공관절 치환술, 십자 인대 재건술, 척추경 나사삽입술 등의 수술에서 그 효용성과 정확성에 대해 많은 평가가 있었다. 최근에는 골종양 의 절제와 종양 절제 후 발생한 골결손 재건에 적용한 증례가 보고되고 있다. 종양과 정상조직 간의 3차원 관계를 보여 줌으로써, 종양의 안전한 절제 뿐 아니라 기능의 보존을 최대화하는데 도움을 줄 수 있다. 그러나, navigation을 골종양 수술에 이용하기 위해서는 사용방법에 대한 완벽한 이해와 정확성 뒤에 숨어있는 오차에 대해 숙지하고 있어야 할 것이다. 저자의 임상 경험을 토대로 종양 수술에서 navigation을 이용할 때 수술 방법과 일반 정형외과 수술에서의 navigation 사용과 다른 점을 기술하고자 한다.

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급성 족관절 외측 인대 파열의 수술적 치료 (The Surgical Treatment of Acute Rupture of the Lateral Ligaments of the Ankle)

  • 이근일;노수인;최익수
    • 대한족부족관절학회지
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    • 제5권1호
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    • pp.5-12
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    • 2001
  • Purpose: To find out the priority of which procedure has had a better outcome both clinically and radiographically between the two groups, one is treated by primary repair and the other by modified Brostr$\ddot{o}$m's procedure, by comparing the postoperative ankle joint stability and the patient's degree of satisfaction. Material and methods: 16 cases were taken into consideration whose number of severed ligaments were at least two or more of the lateral collateral ligaments of the ankle, and also were confirmed intraoperatively. Among them, 8 cases were treated with primary repair and the other 8 cases were treated with primary repair and the other 8 cases by modified Brostr$\ddot{o}$m's procedure. Results: There was no distinguishable difference for the patient's degree of satisfaction between the two procedures above mentioned. In 3 cases treated with primary repair, functional instability was observed. In case of postoperative ankle joint stability, 7 of 8 cases treated by modified Brostr$\ddot{o}$m's procedure has revealed increased joint stability. And 3 of 8 cases which were treated by primary repair have showed postoperative residual instability. Conclusion: Actually, the severed ligament can not maintain its normal strength though several months has elapsed, and possible residual instability could be remained. Therefore, it can be expected that modified Brostr$\ddot{o}$m's procedure also would be a .good method in obtaining suitable ankle joint stability as well as subtalar joint stability because of its reinforcement using extensor retinaculum.

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엘리트 레슬링선수들의 손상유형에 따른 시각적 상사 척도와 회복 기간과의 융복합분석 (Convergence Analysis of the between Visual Analog Scale and Recovery Time according to the Types of Injury of Elite Wrestling Athletes)

  • 김준철;박기준
    • 한국융합학회논문지
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    • 제11권9호
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    • pp.59-63
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    • 2020
  • 본 연구는 엘리트 레슬링선수들이 주로 발생하는 스포츠 손상유형을 알아보고, 그에 따른 시각적 상사 척도와 회복 기간 그리고 시각적 상사 척도와 회복 기간이 어떠한 관계가 있는지 알아보고자 하였다. 손상 유형별 발생률은 포아송 비로 계산하였으며, 손상유형에 따른 시각적 상사 척도와 회복 기간은 일원분산분석을 시행하였다. 또한, 시각적 상사 척도와 회복 기간의 관계를 알아보기 위해 단순선형 회귀분석을 시행하였으며, 모든 통계의 유의성은 α=.05로 하였다. 연구결과 인대 손상이 가장 높았으며, 그다음으로는 근육 손상, 연골 손상 그리고 힘줄 손상 순이었다. 손상유형에 따른 시각적 상사 척도는 통계적으로 유의하였으며(p=.001), 회복 기간에서도 통계적으로 유의하였다(p=.001). 또한, 시각적 상사 척도가 1씩 증가할 경우, 회복 기간은 약 1.89일씩 길어졌다(p=.001). 이러한 연구들은 선수들의 안전한 선수 생활과 스포츠 현장 복귀를 위한 유용한 이론적 배경으로 제공될 것이다.

전열침(傳熱鍼)이 급성 족관절 염좌로 인한 전거비·종비 인대 손상에 미치는 임상적 효과 (The Clinical Effects of Heating-Conduction Acupuncture Therapy for Anterior Talofibular and Calcaneofibular Ligament Injury Induced by Acute Ankle Sprain)

  • 안순선;허동석
    • 한방재활의학과학회지
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    • 제20권3호
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    • pp.119-129
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    • 2010
  • Objectives : The purpose of this study is to investigate the clinical effects of heating-conduction acupuncture therapy on ligament injury induced by acute ankle sprain. Methods : From september 16, 2008 to April 17, 2010, the 28 outpatients who had admitted to department of oriental rehabilitation medicine, Dae-Jeon oriental Medical hospital, Dae-Jeon university with acute ankle sprain were performed heating-conduction acupuncture therapy on anterior talofibular and calcaneofibular ligament injury. To evaluate the efficiency of heating-conduction acupuncture therapy, pain threshold with pressure algometer and visual analogue scale(VAS) were applied before treatment and after 1st, 2nd treatment. Results : 1. The pain threshold and the VAS score showed statistical significant improvement after 1st treatment on calcaneofibular and anterior talofibular ligament injury. 2. The VAS score after 2nd treatment on calcaneofibular and anterior talofibular ligament injury showed statistical significant improvement compared with that after 1st treatment. 3. The pain threshold after 2nd treatment on calcaneofibular and anterior talofibular ligament injury did not show statistical significant improvement compared with that after 1st treatment. 4. The difference between anterior talofibular and calcaneofibular ligament injury was not statistical significant in pain threshold and VAS score. Conclusions : Heating-conduction acupuncture therapy has clinical effects of pain reduction on patient with calcaneofibular ligament injury as well as anterior talofibular ligament induced by acute ankle sprain.

견봉-쇄골관절 탈구를 동반한 오구 돌기 골절의 봉합나사를 이용한 수술적 치료 - 증례 보고 - (Surgical Treatment Using Anchor Suture of Coracoid Process Fracture with Acromioclavicular Joint Dislocation - A Case Report -)

  • 정운섭;이상수;유연식;김도영;박근민
    • Clinics in Shoulder and Elbow
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    • 제12권2호
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    • pp.240-244
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    • 2009
  • 목적: 본 논문은 오구 쇄골 인대가 온전하면서 견봉-쇄골 관절 탈구를 동반한 오구 돌기 골절에서 봉합나사를 이용한 고정술의 소개와 임상적 결과를 알아보고자 하였다. 대상 및 방법: 26세 남자 환자로 제3형 견봉-쇄골 탈구와 동반된 오구돌기 골절을 최초로 봉합 나사를 이용한 간접적 정복술을 시행하였다. 결과: 술 후 3개월에 골절의 완전한 유합 및 정상 견관절 운동 범위 및 기능의 회복을 얻었으며, 합병증의 소견은 없었다. 결론: 봉합나사를 이용한 간접적 정복 및 고정술은 견봉-쇄골 관절 탈구를 동반한 오구돌기 골절의 치료에 있어서 안전하고 유용한 수술 방법으로 사료된다.

전방십자인대 수술이 시행되어진 슬관절과 정상 슬관절의 유효 모멘트암 (effective moment arm) 비교 분석 (Bilateral Comparison of Effective Moment Arms of the Quadriceps force on Unilateral ACL-Reconstructed Individuals)

  • 채원식
    • 한국운동역학회지
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    • 제13권1호
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    • pp.13-21
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    • 2003
  • The purpose of this study is (a) to estimate effective moment arms of quadriceps forces and (b) to compare the $d_e$ between the ACL-reconstructed and uninjured knees from the same individual. One female (20 yrs old, 2 yrs post-op, hamstring tendon autograft) and two males (22 yrs old, 2 yrs post-op; 28 yrs old, 4 yrs post-op; Patellar tendon autografts for both). Sagittal view radiographs were obtained for 6-7 different angles $(range\;5^{\circ}-110^{\circ})$ from each knee. The do was determined by the method of Chow et al. (1999a). The results showed that the maximum de values ranged from 4.61 to 5.59cm and 4.59 to 4.89cm for the ACL-reconstructed and uninjured knees, respectively. The maximum $d_e$ occurred between $35^{\circ}\;and\;50^{\circ}\;and\;20^{\circ}\;and\;50^{\circ}$ for the ACL-reconstructed and uninjured knees, respectively. The minimum do values ranged from 4.12 to 4.35 cm and 3.12 to 3.63cm for the ACL-reconstructed and uninjured knees, respectively. The effective moment arm of the knee extensor affects the loads on knee ligaments during knee-extension exercises. Because apparent differences in the moment arm of the quadriceps in different participants, it is very important to use personalized knee joint geometry for the computation of knee joint force. In the present study, no noticeable bilateral difference was found in the male subjects. However, apparent bilateral differences in de were observed in the female subject. This suggests that the effects of ACL reconstruction surgery on patellar mechanism deserve further investigation.

코의 "진피연골인대"의 해부학 (Anatomy of Pitanguy's Dermocartilaginous Ligament)

  • 박덕준;한승규;정성호;김우경
    • Archives of Plastic Surgery
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    • 제34권2호
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    • pp.176-180
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    • 2007
  • Purpose: Pitanguy conducted a series of anatomical studies on "dermocartilaginous ligament" of the nose. However, information on its structure is as yet insufficient, especially in terms of its origin, insertion, and relationships with surrounding tissues. In addition, some of the histologic findings described by Pitanguy are controversial. The present study was undertaken to clarify the anatomy of the "dermocartilaginous ligament". Methods: Sixteen cadaver noses were examined macroscopically and histologically to determine the presence, origin, insertion, composition, and relationship of the "dermocartilaginous ligament" with surrounding structures. Results: The structure originated from the deep layer of the transverse nasalis muscle and terminated at the caudal edge of the septal cartilage in all 16 cadavers. However, in three cadavers the insertion extended to the orbicularis oris muscle. No direct connection was found between the structure and dermis of dorsal nasal skin. The dermocartilaginous ligaments were mainly composed of a condensation of thin collagen bundles, which were interwoven and without any regular orientation. Elastic fibers were also present in small numbers, and there were few amorphous ground substances. Neither muscle fibers nor chondrocytes was identified within dermocartilaginous ligaments. Conclusion: Our macroscopic and histologic findings of the structure do not support the use of the term "dermocartilaginous ligament". According to its origin, insertion, and histologic findings, we recommend that this structure be referred to as the "median musculocartilaginous fascia".

가토의 굴곡건 손상모델에서 Mitomycin-C가 인대 유착 방지에 미치는 영향 (The Effect of Mitomycin-C on Preventing Adhesion of Injured Flexor Tendon in Rabbit Model)

  • 성정화;강소라;김양우
    • Archives of Plastic Surgery
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    • 제37권4호
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    • pp.329-334
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    • 2010
  • Purpose: Adhesion after flexor tendon injury is a result of fibrosis between tendon and tendon sheath. This, finally interfere with gliding mechanism of tendon and results in functional problem of hands. Therefore, there have been many trials to reduce adhesion around the tendon. However, there is no standard procedure clinically practiced in hospitals. Mitomycin-C is an antineoplastic alkylating agent that decrease fibroblast proliferation and scar formation. It is commonly used in many surgery to reduce postoperative adhesion. This study was designed to observe the effect of Mitomycin-C on preventing adhesion in injured flexor tendon. Methods: The deep flexor tendon of digit 2 and 4 in the left forepaw of 15 New Zealand White rabbits were subjected to partial tenotomy. In study group, injury site was exposed to a single 5-minute application of Mitomycin-C, and in control group was left untreated. Digit 2 and 4 in the right forepaw of each rabbit were considered as nonadhesion control group. After 2 weeks, the animals were sacrificed and digits were amputated for biomechanical test and histological study. Results: In biomechanical study to measure yield point, mean yield point of non-adhesion control was $17.43{\pm}2.33$ and $25.07{\pm}4.03$ for adhesion control, which proves increase of adhesion in adhesion control group (p<0.05) in 95% confidence. In Mitomycin-C group, mean yield point was $12.71{\pm}4.97$. Compared with adhesion control, there was decrease in adhesiveness in Mitomycin-C group (p<0.05) in 95% confidence. In histological study, the result of adhesion control revealed massive adhesions of bony structure, fibrotic tissue and tendon structure with ablation of the border. However in Mitomycin-C group, we could find increased fibrotic tissue, but adhesion is much lesser than adhesion group and borders between structures remain intact. Conclusion: This study suggests that Mitomycin-C can significantly reduce adhesion of injured flexor tendon in rabbit model.

토끼 모델에서 굴근 인대 봉합 후 가딕스®의 유착 방지 효과 (Adhesion Prevention with Guardix® (Sodium Hyaluronate) After Flexor Tendon Repair in Rabbits)

  • 김학영;장학;민경원
    • Archives of Plastic Surgery
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    • 제36권5호
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    • pp.543-547
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    • 2009
  • Purpose: Adhesion is the most common and troublesome complication after repair of flexor tendon injury. Recently, use of sodium hyaluronate derivatives for adhesion prevention is increasing. A commercial product, Guardix$^{(R)}$, sodium hyaluronate(NaHe) combined with carboxymethylcellulose(CMC) has been newly developed as a preventive material for adhesion. We have investigated its effect in rabbits. Methods: Twenty seven male New Zealand white rabbits were operated under ketamine anesthesia. After tendon repair in zone II of the hind paw, Guardix$^{(R)}$(experimental group) or normal saline(control group) was administered. Biomechanical tests were performed to estimate adhesion formation at 2, 4, 8, and 12 weeks after the operation. Maximum tensile load to flex the distal interphalangeal joint 50 degree from its resting state(MTL50) was measured, depicting the amount of adhesion formed. Subsequently, breaking strength was assessed. Results: There were no postoperative complications such as infection, wound dehiscence, or hematoma. MTL50 was significantly lower in the experimental group than in the control group at 4, 8, 12 weeks (p<0.05). Mean value of MTL50 was 6.64N in the experimental group and 28.53N in the control group at 12 weeks after surgery. There were no significant differences in breaking strength. Conclusion: Our results indicate that Guardix$^{(R)}$ is helpful in reducing adhesion formation and does not interfere with normal healing processes of the tendon.

사람의 치수 및 치주인대 세포에 대한 Bioaggregate 시멘트의 생체적합성에 대한 연구 (Biocompatibility of bioaggregate cement on human pulp and periodontal ligament (PDL) derived cells)

  • 정주령;김의성;신수정
    • Restorative Dentistry and Endodontics
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    • 제35권6호
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    • pp.473-478
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    • 2010
  • 연구목적: 본 연구는 인간의 치수 및 치근단 조직에서 유리된 세포를 이용하여 비교적 최근 소개된 Bioaggregate의 생체친화성을 평가하는 데에 있다. 연구 재료 및 방법: 사람의 발거치로 부터 치수 및 치근단 조직에서 배양된 세포를 이용하였다. Bioaggregate와 white MTA를 혼합하여 세포배양판에 적용한 후 같은 수의 세포를 배양하였다. 1, 3, 그리고 7일 후 위상차현미경을 사용하여 세포의 부착과 성장을 관찰하고 cell viability test를 시행하였다. 얻어진 결과는 Student t-test및 one way ANOVA를 이용하여 분석하였다. 결과: 두가지 종류의 세포 모두 Bioaggregate와 MTA가 혼합된 배양판에서 잘 성장하였으며 Bioaggregate군에서는 inhibition zone이 관찰되지 않았다. Cell viability test에서 두 그룹간 통계적인 유의성 차이는 없었다. 결론: Bioaggreagete는 치수 및 치근단 세포에 대하여 MTA와 유사한 세포친화성을 보였다.