• 대한정형외과스포츠의학회지
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• 제5권1호
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• pp.75-80
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• 2006

목적: 해부학적 정복이 가능한 요골두 골절에 대하여 Acutrak 나사를 이용한 고정술의 치료 결과와 유용성에 대해 알아보고자 하였다. 대상 및 방법: 2001 년 5월부터 2003년 2월까지 본원에서 요골두 골절에 대해 수술한 12 예중 Acutrak 나사 고정술로 치료한 7 예를 대상으로 하였다. 추시 기간은 최소 6개월부터 최장 30개월로 평균 1.2년이었고, 평균 나이는 47세였다 손상의 원인은 낙상이 4예, 교통사고가 3예이었다. 치료 결과 평가 방법은 Mayo Clinic에서 발표한 Functional Rating index를 이용하였다 결과: Mayo Clinic의 Functional Rating Index를 이용한 기능적 평가상 우수가 2예, 양호가 5예였다 방사선학적 소견 상 모든 예에서 골유합 소견을 보였고, 부정 유합이나 나사 이완, 이소성 골형성, 감염, 외상 후 퇴행성 변화 등의 합병증은 없었고 수술 후 건측과 비교하여 운동장애도 보이지 않았다. 결론: 본원에서 시행한 요골두 골절의 Acutrak 나사 고정은 요골두 부분의 안전지대에 대한 고려없이 시행 가능하며 방사선학적 및 임상적 평가에서 만족할 만한 결과를 보였고, Acutrak 나사의 형태학적 특성상 골절의 선상 형태에 대하여 근위 요척골관절에 영향을 주지 않으며, 강한 고정력을 얻을 수 있는 술식으로 사료된다.

• 대한골관절종양학회지
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• 제11권2호
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• pp.111-117
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• 2005

목적: 15세 이하의 소아에서 골종양에 2차적으로 발생한 대퇴골의 병적 골절의 치료 결과에 대해 알아보고자 하였다. 대상 및 방법: 1995년 1월부터 2004년 6월까지 골종양에 2차적으로 발생한 대퇴골의 병적 골절로 치료받았던 환자 중 1년 이상 추시가 가능하였던 18명, 20예를 대상으로 하였다. 평균 연령은 10.2세였고 평균 추시 기간은 42.5개월이었다. 결과: 골절 부위는 대퇴 근위부 14예, 간부 3예, 원위부 3예였으며, 원인 골종양은 섬유성 이형성증 9예, 단순 골낭종 4예, 동맥류성 골낭종 4예, 비골화성 섬유종 2예, 호산구성 육아종 1예였다. 치료 방법으로 골절에 대해서는 11예에서 석고고정을 이용한 보존적 치료를, 8예에 대해서는 내고정을 1예에서는 외고정을 시행하였다. 원발 종양에 대해서는 관찰만 시행한 경우가 11예, 소파술 및 골이식이 8예, 절제술이 1예에서 시행되었다. 다발성 섬유성 이형성증에서 모든 예에서 변형이 발생하여 변형 교정술 및 골수정 내고정술로 더 이상의 변형이나 재골절을 예방할 수 있었다. 결론: 골종양에 2차적으로 발생한 소아 대퇴골의 병적 골절은 그 치료가 어려우나 원발 골종양의 종류 및 그 특성에 따른 적절한 치료 방법을 선택하면 우수한 결과를 얻을 수 있을 것으로 생각된다.

• Biomaterials and Biomechanics in Bioengineering
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• 제2권4호
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• pp.197-206
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• 2015

This paper presents three-dimensional finite element method analyses of the distribution of equivalents stress of Von Mises. Induced around a cavity located in the bone cement polymethylmethacrylate (PMMA). The presences and effect of its position in the cement was demonstrated, thus on the stress level and distribution. The porosity interaction depending on their positions, and their orientations on the interdistances their mechanical behaviour of bone cement effects were analysed. The obtained results show that micro-porosity located in the proximal and distal zone of the prosthesis is subject to higher stress field. We show that the breaking strain of the cement is largely taken when the cement, containing the porosities very close adjacent to each other.

• Journal of Mechanical Science and Technology
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• 제20권12호
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• pp.2168-2177
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• 2006

The purpose of this investigation was to determine the specific fracture mechanics response of cracks that initiate at the stem-cement interface and propagate into the cement mantle. Two-dimensional finite element models of idealized stem-cement-bone cross-sections from the proximal femur were developed for this study. Two general stem types were considered; Rectangular shape and Charnley type stem designs. The FE results showed that the highest principal stress in the cement mantle for each case occurred in the upper left and lower right regions adjacent to the stem-cement interface. There was also a general decrease in maximum tensile stress with increasing cement mantle thickness for both Rectangular and Charnley-type stem designs. The cement thickness is found to be one of the important fatigue failure parameters which affect the longevity of cemented femoral components, in which the thinner cement was significantly associated with early mechanical failure for shot-time period.

• Journal of Chest Surgery
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• 제13권1호
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• pp.72-76
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• 1980

A successful repair of transected descending thoracic aorta was performed in a 44-year-old man. The patient had once been hospitalized in a local clinic for 7 days after a steering wheel injury. Dealing with right Colle`s fracture, he was transferred to this hospital to rule out aortic injury. On admission, a chest PA film and concomitant aortogram revealed an aneurysm of the descending thoracic aorta just distal to the origin of the left subclavian artery measuring 6 cm in diameter and 8 cm in length. He underwent urgent thoracotomy and the injured part of the aorta was replaced with a woven Dacron graft utilizing a Gott`s heparinized aortic shunt. The postoperative course was very smooth except hoarseness and left phrenic nerve palsy due to a blind clamping of the proximal aorta during the operation.

• Journal of Yeungnam Medical Science
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• 제23권1호
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• pp.96-102
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• 2006

Jehovah's Witnesses refuse a transfusion of blood or blood products because of religious beliefs; this refusal at times presents a dilemma for the treating physician. We report a case of a 25-year-old Jehovah's Witness patient who underwent a reoperation for a previous proximal humerus shaft fracture and experienced unexpected massive hemorrhage intraoperatively and postoperatively. The postoperative lowest hemoglobin level was 2.9 g/dl. The patient recovered from the severe anemia without any clinical sequala. We review the legal, ethical and religious issues and suggest the best possible medical care that Jehovah's Witness patient would permit.

• Clinics in Shoulder and Elbow
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• 제25권2호
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• pp.154-157
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• 2022

Periprosthetic joint infection (PJI) is one of the most devastating complications that can occur after shoulder arthroplasty. Although staged revision arthroplasty is the standard treatment in many cases, surgical intervention with debridement, antibiotics, and implant retention (DAIR) can be an effective option for acute PJI. We report a complex case of infected reverse shoulder arthroplasty (RSA) in a 73-year-old male. The patient had been previously treated for infected nonunion of a proximal humerus fracture caused by methicillin-resistant Staphylococcus epidermidis. He presented with a sinus tract 16 days after the implantation of RSA and was diagnosed with PJI caused by Serratia marcescens. The patient was successfully treated with DAIR and was free of infection at the last follow-up visit at 4 years postoperatively.

• 대한족부족관절학회지
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• 제26권1호
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• pp.54-58
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• 2022

Superficial peroneal nerve (SPN) injuries happen occasionally during surgical treatment of fibular fracture, lateral ankle ligament repair, etc. These injuries are caused because of the variable location of the SPN. It is the injuries are usually treated by steroid injections or anticonvulsants. However, neural symptoms may not respond to treatment and may persist and progress to a painful neuroma. Intractable pain may need surgical treatment. We examined two cases of iatrogenic postoperative SPN injury, and we treated them with transection of the SPN and the intraosseous transposition of the proximal nerve stump using the thrombin-fibrinogen complex with satisfactory outcomes. We report these two cases with a review of the relevant literature.

• Clinics in Shoulder and Elbow
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• 제26권3호
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• pp.222-230
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• 2023

Background: Distal biceps tendon repairs are commonly performed using open techniques. A minimally invasive distal biceps tendon repair technique using a speculum and hooded endoscope was developed to improve visualization, reduce soft-tissue dissection, and minimize complications. This paper describes the technique and reports the outcomes of 75 minimally invasive distal biceps tendon repairs. Methods: The operation reports and outcomes of 75 patients who underwent distal biceps tendon repair using this technique between 2011 and 2021 were retrospectively reviewed. Results: Median time to follow-up was 12 months (interquartile range [IQR], 6-56 months). Primary outcomes were function as measured by the Disabilities of Arm, Shoulder and Hand Score (DASH) questionnaire, and rate of complications. Median DASH score was 1.7 of 100 (IQR, 0-6.8). There were 2 of 75 (2.7%) re-ruptures of the distal tendon. There were no cases of vascular injury, proximal radius fracture, or posterior interosseous nerve, median, or ulnar nerve palsy. Conclusions: In this series, minimally invasive distal biceps repair was safe and effective with a low rate of major complications. Recovery of function, as indicated by low DASH scores, was satisfactory, and inconvenience during recovery was minimized. Level of evidence: IV.

• Hip & pelvis
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• 제34권3호
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• pp.140-149
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• 2022

The increase in the number of primary total hip arthroplasties that will be performed over the next several decades will lead to an increase in the incidence of periprosthetic fractures around the femoral stem. A search of targeted articles was conducted using on-line databases of PubMed (National Library of Medicine) and articles were obtained from January 2008 to November 2021. Reliable prediction of treatment can be achieved using the Vancouver classification; internal fixation is indicated in fractures involving a stable implant and revision arthroplasty is indicated in those with unstable prostheses. To the best of our knowledge, relatively fewer studies regarding periprosthetic proximal femur fractures of cemented stems have been reported. The focus of this review is on the risk factors and strategies for treatment of these fractures for periprosthetic femoral fractures around a cemented hip arthroplasty.