• 대한정형외과학회지
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• 제54권1호
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• pp.78-83
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• 2019

통풍 결절(tophi)은 통풍의 한 가지 합병증이지만 통증을 유발치 않을 시 진단이나 치료가 지연되기 쉽다. 본 증례는 수년간 거대 결절이 양측 슬개골낭과 슬개골 상부에 있음에도 활동에 별 지장이 없어 치료가 지연된 증례였는데, 환자가 치료의 필요성을 전혀 인식하지 못하여 수술적 치료를 거부하였고 불가피하게 약물 투여 후 경과관찰을 시행하였다. 치료는 상황에 따라 내과적 약물 투여 혹은 외과적 절제술을 시행하게 되는데, 저자들은 일차적 통풍이라 판단하고 수술적 절제 대신 고식적 요법을 택하여 치료 후 6년간 추시를 보고하는 바이다.

• 대한족부족관절학회지
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• 제20권2호
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• pp.84-87
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• 2016

Tarsal tunnel syndrome is an entrapment neuropathy of the posterior tibial nerve or its branches in the fibro-osseous tunnel beneath the flexor retinaculum. This pathology is associated with multiple etiologies, including trauma, space-occupying lesions, and impaired biomechanics. We report a case of tarsal tunnel syndrome associated with gout tophi in a patient with untreated gout along with a review of the relevant literature on tarsal tunnel syndrome.

• 대한관절경학회지
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• 제3권2호
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• pp.155-158
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• 1999

보존적인 치료에 반응하지 않는 급성 염증이 동반된 만성 통풍성 관절염의 치료에 있어 최근 관절경을 통한 시술이 효과적인 것으로 보고되고 있으며 그 시술시 내외적인 여러 요인에 의한 급성 증세발현의 원인인자인 것으로 알려져 있는 통풍결절을 제거한 후 1년의 추시 관찰 결과 증상의 재현이 없어 증례와 함께 보고하는 바이다.

• 대한정형외과학회지
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• 제56권5호
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• pp.440-444
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• 2021

통풍이 진행된 경우, 단일 요산 나트륨결정이 관절과 주위 조직에 침착되어 통풍 결절이 발생한다. 저자들은 우측 무릎의 통증과 관절 운동각도 제한으로 내원한 45세 남자에서 자기공명영상 검사상 종물을 확인하였고 관절경 수술 및 조직검사를 시행하였다. 내측과 외측 반월연골판의 전각을 침범한 통풍 결절이 확인되었으며 이를 수술로 제거하였다. 내, 외측 반월연골판을 동시에 침범한 반월연골판 내 통풍 결절은 문헌상 보고된 적이 없어 이를 문헌 고찰과 함께 보고하고자 한다.

• Journal of Yeungnam Medical Science
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• 제32권1호
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• pp.42-46
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• 2015

Gouty ulcer can be caused by the accumulation of clumps of uric acid in body tissues that lead to acute or chronic inflammation at sites of accumulation. Furthermore, tophi-inhibiting granulation tissue may form a canal that channels microbial infection from the underlying involved joint space, and thus, presents the risk of osteomyelitis development. Accordingly, gouty ulcer must be treated appropriately. In this case, refractory wounds on gouty ulcers at the left shin and left radial ankle were treated by surgical debridement. Negative-pressure wound therapy was used successfully to prevent post-operative delayed wound healing.

• 대한족부족관절학회지
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• 제22권4호
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• pp.156-160
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• 2018

Purpose: Chronic tophaceous gout is a painful and disabling inflammatory disease. Surgical treatment for chronic tophaceous gout is very difficult with many complications. This study evaluated the efficacy of shortening scarf osteotomy on the treatment of chronic tophaceous gout in the 1st metatarso-phalangeal (MTP) joint. Materials and Methods: From January 2006 to December 2015, 14 patients (19 cases) who underwent axial shortening scarf osteotomy for chronic tophaceous gout were reviewed. All patients were male. The average age at the time of surgery was 59.6 years (42~66 years). The minimum follow-up was 24 months. Total removal of the tophi mass with the adhered medial capsule of the 1st MTP joint was attempted. Axial shortening scarf osteotomy was done on the 1st metatarsal shaft. The visual analogue scale (VAS) for pain and the American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score was assessed preoperatively and postoperatively. The range of motion (ROM) of the 1st MTP joint was also compared pre- and postoperatively. Results: The average size of the extracted tophaceous mass was 32 mm. The mean amount of the length of metatarsal shortening was 4.9 mm. The mean ROM of the 1st MTP joint was improved from $30.4^{\circ}$ to $62.3^{\circ}$. The mean AOFAS forefoot score improved from 51.4 to 86.6 points. The mean VAS for pain improved from 4.6 to 0.3 points. Conclusion: The axial shortening scarf osteotomy used on chronic tophaceous gout could reconstruct the 1st MTP joint with an improved ROM and was free of pain. Axial shortening scarf osteotomy is suggested as a useful and effective method for the treatment of chronic tophaceous gout.