• 대한관절경학회지
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• 제3권2호
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• pp.132-137
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• 1999

목 적 : 관절경하에서 전위된 경골극 골절을 suture hook와 PDS를 이용하여 견인봉합술을 실시하고 그 수술수기와 임상적 결과를 보고하고자 한다. 재료 및 방법 : 1997년 2월부터 1998년 6월까지 견인봉합술을 시행한 12명의 환자중 최소 1년이상 추시관찰이 가능하였던 7명의 환자를 대상으로 하였다. 7예 모두 수상후 3주이내의 급성 손상이며 증상 발현부터 수술까지의 평균 기간은 6.1일이었다. 7예중 4예에서 반월상 연골판파열, 내측 측부 인대손상등의 동반손상이 발견되었고 경골극 골절에 대한 수술시 동반손상에 대한 수술적 치료도 병행하였다. 결 과 : 추시기간은 평균 16.6개월로서, 7례 모두에서 골유합을 얻을수 있었으며 골유합시기는 평균 7.4주였다. 후방십자인대 견열골절 및 외측 반월상 연골판손상이 동반된 환자중 1례에서 관절 운동의 제한이 있었으나 수술후 1년 뒤 관절경적 유착 제거술이후 정상 관절 운동 범위를 보였다. 1명의 환자에서 경도의 전방 불안정성의 소견을 보였으나 자각증세나 일상생활의 제한이 없었다. 결 론 : Suture hook과 PDS를 이용한 관절경적 수술은 골편이 작거나 분쇄골절인 경우에도 해부학적 정복을 얻을수 있고, 조기 재활도 가능하므로 전위된 경골극 골절치료에 있어서 유용한 방법의 하나로 사료된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권6호
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• pp.273-279
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• 2014

Purpose: This study assessed the association between eye symptoms (enophthalmos or diplopia) and site of damage, volume, deviated inferior rectus muscle (IRM) and type of fracture with computed tomography (CT). The intent is to anticipate the prognosis of orbital trauma at initial diagnosis. Methods: Forty-five patients were diagnosed with fractures of the inferior wall of one orbit. Fracture area, volume of displaced tissue, deviated IRM, and type of fracture were evaluated from coronal CT by one investigator. The association of those variables with the occurrence of eye symptoms (diplopia and enophthalmos) was assessed. Results: Of 45 patients, 27 were symptom-free (Group A) and 18 had symptoms (Group B) of enophthalmos and/or diplopia. In Group B, 12 had diplopia, one was enophthalmos, and five had both. By CT measurement, group A mean area was $192.6mm^2$ and the mean volume was $673.2mm^3$. Group B area was $316.2mm^2$ and volume was $1,710.6mm^3$. The volume was more influential on symptom occurrence. Each patient was categorized into four grades depending on the location of IRM. Symptom occurrence and higher grade were associated. Twenty-six patients had trap-door fracture (one side, attached to the fracture), and 19 had punched-out fracture (both sides detached). The punched-out fracture was more strongly associated with symptoms and had statistically significantly higher area and volume. Conclusion: In orbital trauma, measurement of fracture area and volume, evaluation of the deviated IRM and classification of the fracture type by coronal CT can effectively predict prognosis and surgical indication.

• 대한정형외과스포츠의학회지
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• 제7권1호
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• pp.55-57
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• 2008

족부 주상골의 골절 및 거주상 관절의 탈구는 그 빈도가 매우 드물다. 이에 대하여는 관혈적 혹은 비관혈적의 정복술이 요구된다. 저자들의 단독 주상골 골절 및 거주상 관절 탈구에 관하여 관혈적 정복술 및 K-강선을 이용한 내고정을 이용한 치료를 하여 만족할만한 결과를 얻었으며, 문헌 고찰과 함께 보고하는 바이다.

• Clinics in Shoulder and Elbow
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• 제9권2호
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• pp.231-234
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• 2006

We experienced a case of impingement caused by a bone fragment which was impacted between acromion and humeral head in a child. The bone fragment came from antero-inferior glenoid fracture. Satisfactory clinical results and stability were obtained by arthroscopic bone fragment removal. In case that bone fragment is located in the upper shoulder joint and results in impingement, We must consider not only greater tubercle fracture but also glenoid fracture. Magnetic resonance imaging can assist in the preoperative diagnosis.

• 대한족부족관절학회지
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• 제12권2호
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• pp.230-233
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• 2008

The avulsion fracture of the calcaneal tuberosity is rare injury. Usually, it occurs from indirect trauma in old patients with osteoporosis or in patients with diabetic neuropathy. Especially, the bone and joint damage occurred in active patient with severe sensory loss or arthropathy related to nerve damage regardless of the cause is referred to neuropathic arthropathy. Generally, a patient with nondisplacement or minimally displacement is treated by conservative therapy and a patient with severe displacement is treated by open reduction and internal fixation. We experienced a 33 years-old woman with diabetes mellitus who had the displaced avulsion fracture of the calcaneal tuberosity without significant trauma and did not treat. We report upon this case at the 2 years follow-up.

• 한국임상수의학회지
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• 제34권2호
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• pp.115-118
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• 2017

A Korean goral (immature, female) was presented with paraplegia following motor vehicle trauma. The patient was diagnosed with an L5-6 vertebral fracture-luxation based on digital radiographs. Surgical reduction and stabilization of the fracture-luxation were performed via a dorsal approach to the lumbar spine. It was confirmed in surgery that the patient had L5-7 spinous process fractures, L6 bilateral articular process fractures, and an L5-6 luxation. Free fragments were removed and the luxation was reduced. During reduction, caudodorsal dislocation of the L5 caudal vertebral end plate was discovered and the displaced end plate was removed. The L5-6 vertebral luxation was stabilized using pins and bone cement. However, the presence of an intact spinal cord was not confirmed. Two weeks postoperatively the patient became dyspneic and arrested. A necropsy was performed, which revealed that the surgical stabilization was intact. Pulmonary edema was identified and the immediate cause of death was determined to be systemic inflammatory response syndrome.

• 대한족부족관절학회지
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• 제8권1호
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• pp.86-91
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• 2004

Purpose: To evaluate the methods and results of the surgical treatment in the trimalleolar fracture of the ankle. Materials and Methods: We analysed the results of the ankle trimalleolar fracture which were treated with open reduction and internal fixation from January 1999 till September 2003. There were 45 patients who had at least six months follow up, 16 men, and 29 women. We have analysed the mechanism of injury, methods of operation and postoperative complications. Results: The results were assessed on ankle AP, lateral and mortise X-rays and retrospective chart review. There were 30 supination-external rotation, 13 pronation-external rotation, 2 pronation-abduction in the mechanism of injury by Lauge-Hansen classification. Cases of the posterior malleolar fracture which involved more than 25% of the weight bearing surface were 7 (15.6%). Medial malleolar mono-fixation was done in 5 cases, fibular mono-fixation in 2 cases, bimalleolar fixation in 32 cases, trimalleolar fixation in 6 cases. 38 cases (84.4%) were good or excellent in clincal assessment and 39 cases (86.7%) were good or excellent in radiological assessment according to the criteria of the Meyer. There was no difference of results among the surgical treatment methods. Conclusion: The results of our study indicate that the rigid fixation with early ankle motion and weight bearing is needed in ankle trimalleolar fracture. But minimal fixation is not bad in slight displaced fracture. Both anterior approach and posterior approach were useful methods to stabilization the posterior malleolar fracture. And pre-operative evaluation to detect the hidden soft tissue injuries and fracture mechanism is very important to avoid the failure.

• Clinics in Shoulder and Elbow
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• 제6권2호
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• pp.131-137
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• 2003

Purpose: Unstable Neer type II lateral end fracture of clavicle may be required operation. The purpose of this study is the effectiveness of the use of Hook plate in the management of unstable Neer type II fractures. We preliminary reported the results of Unstable Neer type II lateral end fracture of clavicle using by Hook plate. Material and Methods: From May 1998 to May 2002, we operated 6 cases unstable Neer type II lateral end fracture of clavicle with Hook plate by one surgeon. We checked radiologic evaluation and disappearance of pain per 1 week, and evaluated improvement of range of motion per 2 week. And we followed up at each interval 3 months,6 months, 12 months and after that per 6months interval, at that each time we checked stress radiogram of shoulder and functional evaluation. The shoulder function was evaluated using Modified Shoulder Rating Scale (MSRC) for Distal Clavicle Fracture and UCLA score. Average follow up was on 37.2 (12∼57) months. Results: All 6 patients were regained satisfactory function. Average MSRC for distal clavicle fracture was 17.3 (15∼20) and average UCLA score was 33.2 (31∼35) at last follow up. Conclusion: There are many advantage of the use of Hook plate on management of unstable Neer II distal clavicle fracture in spite of several disadvantage. There have not yet been reported in our country. So we obtained good to excellent clinical result in surgical treatment of 6 cases on type II displaced lateral end fracture of the clavicle. But we think that more cases will be review and longer follow up will be needed in the future.

• Clinics in Shoulder and Elbow
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• 제19권1호
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• pp.2-7
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• 2016

Background: The purpose of this study is to compare the radiological and clinical outcomes after open reduction and plate fixation of midshaft clavicle fractures between patients who achieved successful anatomical reduction and those who had a remaining fracture gap even after open reduction and plate fixation, and were thus treated with additional demineralized bone matrix (DBM). Methods: This retrospective analysis was conducted on 56 consecutive patients who underwent open reduction and internal fixation using a locking compression plate for acute displaced midshaft clavicle fractures, and who underwent radiographic and clinical outcome evaluations at least 6 months postoperatively. The outcomes between those who achieved perfect anatomical reduction without remnant gap (n=32) and those who had a remaining fracture gap even after open reduction and plate fixation treated with additional DBM (n=24) were evaluated. Results: There were no differences in the use of lag screws or wiring and operation time (all p>0.05) between those with and without remnant gap. No difference in the average radiological union time and clinical outcomes (satisfaction and Constant score) was observed between the two groups (all p>0.05). However, significantly faster union time was observed for AO type A fracture compared with other types (p=0.012), and traffic accident showed association with worse clinical outcomes compared with other causes of injury. Conclusions: Surgical outcome of midshaft clavicle fracture was more affected by initial fracture type and event, and re-reduction and re-fixation of the fracture to obtain a perfect anatomical reduction spending time appears to be unnecessary if rigid fixation is achieved.

• 대한족부족관절학회지
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• 제11권1호
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• pp.67-71
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• 2007

Purpose: To evaluate clinical results of the 5th proximal metatarsal intraarticular fracture (Zone I) with displacement treated operatively and to evaluate predisposing factors of the 5th proximal metatarsal fracture (Zone I). Materials and Methods: 11 patients treated for the 5th proximal metatarsal fracture (Zone I) operatively and 10 patients treated conservatively between Jan 2003 and Dec 2005, were followed for more than one year. Functions were graded by AOFAS foot scoring system and union time and postoperative complications were also evaluated. Calcaneal pitch angle was also evaluated. Results: Clinically there were no much difference in results. Clinical points were 94.5 in the operative group and 92.3 in the conservative group. At the last follow-up, the radiographic results showed union in all cases. During the follow-up period, there were no significant complications. But in the conservative group, displaced fracture with calcaneal pitch angle over 30 degree tends to show delayed union and time to loss of pain tends to be prolonged. Conclusion: Calcaneal pitch angle is thought to predisposing factor for 5th metatarsal base fracture. Operative treatment is viable option for the 5th proximal metatarsal intraarticular fracture with displacement and with calcaneal pitch angle over 30 degree. In cases of cavovarus foot deformity, we think operative treatment should be considered with deliberation and long term follow-up study for peroneal tendinopathy should be needed.