• 대한족부족관절학회지
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• 제10권1호
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• pp.101-104
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• 2006

Occasionally, extensor hallucis longus tendon (EHL) ruptures becames open by laceration and spontaneous rupture of EHL that has previous story of diabetes mellitus, steroid injection, systemic steroid administration, operation and rheumatoid arthritis. But, closed traumatic EHL ruptures are reported rarely. Especially, we diagnosed the closed EHL ruptures in TaeKwonDo players. We reported the 2 patients, differently treated end to end anastomosis and EHL transfer, had the course and treatment methods. Be care the prognosis can be altered according to the treatment time and method.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권1호
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• pp.55-65
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• 2005

Most patients with temporomandibular disorder can be treated conservatively. However, open TMJ surgery can be needed in some patients. We analysed the patients with TMD which open surgery has performed since 1998. Open surgery was carried out in 8 patients. Age ranged from 22 to 61 years, with a mean of 42.8years. All patients were male. Final diagnosis was obtained based upon clinical, radiographic and operative finding as follows; habitual luxation, bony ankylosis, traumatic arthritis, disc displacement with destructive change, disc displacement and adhesion. Etiologic factors included trauma(4), infection(2), and unknown(2). Open surgery included arthroplasty with either of condylectomy, eminectomy, meniscoplasty, capsurrohaphy. All patients were recovered uneventfully without severe complications. Some mouth opening limitation and mouth opening deviation remained. Postoperative aggressive physical therapy and careful follow up were performed. In conclusion, open TMJ surgery must be considered in organic disease such as ankylosis, tumor and TMD without favorable recovery after long-term conservative therapy.

• Clinics in Shoulder and Elbow
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• 제12권2호
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• pp.264-270
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• 2009

목적: 주관절은 인체에서 가장 안정적인 관절 중 하나지만, 견관절 다음으로 탈구와 골절이 흔히 발생한다. 이러한 손상은 발생 당시 기전과 환자의 나이 그리고 충격에 따라 다양하게 나타나는데 적절한 치료에도 불구하고 여러 가지 합병증들이 발생 가능하다. 이에 저자들은 외상후 합병증을 고찰하고자 한다. 대상 및 방법: 저자들은 일반적인 주관절 탈구의 합병증인 관절 운동제한, 불안정성, 그리고 관절 주위 이소성 골형성의 원인과 치료 등에 대해 기술하였다. 결과 및 결론: 주관절 주위 골절 이후 발생 가능한 합병증 중 부정유합, 불유합, 외상성 관절염 등에 대한 그 기전과 치료에 대해 기술하고자 한다.

• 대한족부족관절학회지
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• 제10권1호
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• pp.92-95
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• 2006

Purpose: Ankle fusion that is operated on severe ankle arthritis has its weakness in that normal walking is impossible, even though the result is pretty good. As a alternative choice, total ankle replacement pursues the longer survivorship with material improvement. However, it is not yet known how much range of motion is possible after the replacement, or how it has changed overtime. Therefore, we need an analyzation for that. Materials and Methods: A retrospective review of sixty-seven patients undergoing STAR total ankle replacement at our institution between 1998 and 2002 was conducted. Of those, twenty-six (39%) had complete sets of full dorsiflexion and plantar flexion lateral radiographs both between "immediate" postop and at a minimum of 2-years follow-up and no revision procedure during that time. The mean age of these patients was 63.2 years when the surgery was done; the etiology of arthrosis was 21(81%) post-traumatic/degenerative, 4 rheumatoid and 1 psoriatic. Results: Average "immediate" ankle range of motion was $15.9^{\circ}$, and total foot (non-ankle) motion was $20.6^{\circ}$. At one, two, and three years the average ankle and total foot ranges of motion were $17.4^{\circ}$, $17.6^{\circ}$, $15.6^{\circ}$ and $21.0^{\circ}$, $22.0^{\circ}$, $21.2^{\circ}$ respectively. Statistically there was no significant difference between "immediate" postop motion and one to three years postop (all p>0.05). Conclusion: The range of motion after the STAR total ankle replacement is maintained from the "immediate" postoperative range of motion, but not increased, in the 1-3 year post replacement period.

• 대한족부족관절학회지
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• 제1권1호
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• pp.30-37
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• 1997

Pilon fracture is an intraarticular fracture of distal tibia. It is high energy injury with significantly associated soft tissue damage, bone comminution, and articular surface disruption. Until recently, this treatment has followed the AO principles, Because the risk of complications outweighs potential benefits, the principle of a Pilon fracture treatment are changing. Newer techniques using articulated external fixation minimize disturbance of the soft tissue envelope and have decreased these complications. Series of 5 patients with Pilon fracture were treated by articulated external fixator and followed up more than 12 monthes at the Department of orthopaedic surgery, Kang Dong Sacred Heart Hospital, College of medicine, Hallym University. The results were as follows: 1. The type of fracture were type C2(3 cases),type C3(2 cases) according to AO-$M{\ddot{u}}ller$ classification. 2. The clinical results according to functional criteria by Mast and Teipner were good in 4 cases and poor in 1 case, which is an old fracture. 3. Techniques utilizing articulated external fixator were associated with satisfactory results and appeared to significantly decrease the incidence of soft tissue complication, post-traumatic arthritis, osteoporosis, and fibrosis of ankle joint.

• 대한족부족관절학회지
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• 제13권2호
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• pp.156-161
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• 2009

Purpose: The fracture of talus has critical complications and results in various clinical outcomes. The purpose of this study is to evaluate clinical outcome and influence on involvement of ankle and subtalar joint. Materials and Methods: From December 1999 to December 2008, a total of 66 fractures and dislocations of talus was treated with minimal 9 months follow up period. Ankle-hindfoot scale of the American Orthopedic Foot & Ankle Society (AOFAS) was used to evaluate the clinical outcome. The complications and sequential radiologic findings were also analyzed. Results: There were 28 neck fractures, 11 lateral process fractures, 10 body fractures, 7 osteochondral fractures, 4 posteromedial tubercle fractures and 4 medial process fractures. In 38 cases, there were concomitant injuries. Ipsilateral ankle fracture, which found in 19 cases, was most common. The surgical treatment was performed in 36 cases. Mean AOFAS score was 85.5 (range, 72 to 96). In 13 of 47 cases, one or more fracture lines involving weight bearing surface were confirmed. The involvement of ankle or subtalar joint had resulted in unsatisfied outcome. Complications were developed as follows, post-traumatic arthritis in 8 cases, avascular necrosis in 3 cases, and deep infection in 2 cases. Conclusion: The involvement of ankle or subtalar joint in fractures of talus seemed to be common and to impact the clinical outcome. Meticulous consideration about that will be positively necessary.

• 대한족부족관절학회지
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• 제9권1호
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• pp.99-104
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• 2005

Purpose: The purpose of this study was to investigate usefulness of locking compression plate (LCP) as an open reduction technique by evaluating clinical results obtained from the patients with lateral malleolar fracture treated by internal fixation using LCP after open reduction. Materials and Methods: Among the patients with lateral malleolar fracture, the 28 patients who were treated by internal fixation using Locking compression plate after an open reduction and were able to be followed up for more than 6 months were included in this study. Final postoperative evaluation was done based on the Meyer's clinical and radiologic evaluation system. Results: All cases achieved anatomical reduction and fixation of the reduction postoperatively. 28 minutes were taken meaningly from the incision to the fixation of LCP plate after the anatomical reduction. Everage bony union time was 8.2 weaks, and the result was excellent in 23 cases (82%), good in 5 cases (17%) and poor result was abscent according to the criteria of Meyer et al. One case of post traumatic arthritis and one case of superficial infection on the operation site were found, but non-union, delayed union and malunion were not occurred. Conclusion: The internal fixation after open reduction using LCP is an effective treatment method in treating lateral malleolar fracture of the ankle since it offers advantages including easy application and a greater stability due to its capability of maintaining exact anatomical reduction even though the screw does not penetrate the medial cortex of fibular to add the stability and rigidity of the fixation.

• 대한족부족관절학회지
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• 제3권1호
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• pp.40-48
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• 1999

The neck of the talus is its most vulnerable and fragile segment, because of narrow diameter, devoid of hyaline padding and honeycombed internally by vascular channels etc. Talar neck fractures comprise 50% of all major to the talus. The majority occurs as a result of high-energy injuries, such as motor vehicle accidents or fall from a height. Anatomically, talar surface is covered mainly with articular cartilage and blood supply to the talus is very poor. So, complications, such as non-union, avascular necrosis and post traumatic arthritis, are frequent. The authors reviewed fourteen cases of talar neck fractures treated in our clinics from Jan. 1992 to Mar. 1997, and average follow-up period was over 15 months. The results obtained were as follows; 1. Patients' average age was 31.2 years. 2. The most common cause was traffic accident(9/14, 64%), and hyperdorsiflexion injury of the ankle was common mechanism of the fractures. 3. According to the modified Hawkins classification, type I was four cases, type II was nine cases, type III was one case and type IV was no case. 4. Hawkins sign of subcortical radiolucency was found in 64% (9/14) of the fractures. 5. Avascular necrosis was occurred in 21% (3/14) of the fractures(in two cases of type II fractures, and in one of type III). 6. According to the Hawkins criteria, four cases in type I, five in type II were an excellent result. Two cases, one in type II and one in type III were good result, and two in type II were fair. One in type II was poor result.

• 대한족부족관절학회지
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• 제1권2호
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• pp.119-125
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• 1997

The fracture and fracture-dislocation of the neck of the talus (Hawkins' type I-IV) are uncommon injuries and represent only 0.12 to 0.32% of all fracures. Authors clinically evaluated in 12 cases Whom treated fracures of the neck of the talus, at department of orthopaedic surgery, Sun General Hospital, from 1990 to 1996, and the following results are obtained. 1. Of 12 cases, there were 11 males and 1 female, average age was 30 years. 2. Causes of fracture was fall down injury in 7 cases(58%), traffic accident in 4 cases(33%), direct trauma in 1 case(8%). 3. According to the classification by Hawkins' type I in 2 cases(17%), type II in 7cases (58%), type III in 3cases(25%). 4. Associated injuries were calcaneal fracture in 3 cases, fracture-dislocation of talus in 3 cases, subtalar dislocation in 3 cases, medial malleolar fracture in 5 cases, soft tissue injury in 3 cases, femur and tibia fracture in 1 case, and lumbar Spine compression fracture in 1 case. 5. Average time to operation after injury was 2.5 days. 6. In 2 cases were treated conservatively and 10 cases were treated open reduction and internal fixation with screw or K-wire. 7. Complications were avascular necrosis in 4 cases, post traumatic arthritis in 2 cases, skin necrosis in 4 cases, and then ankle fusion was done in 2 cases. 8. High rate of complication was seen in the talar neck fracture associated with calcaneal fracture. In the analysis of above results, evaluated by Hawkins' scoring system were excellent to fair in 75%.

• 생약학회지
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• 제43권2호
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• pp.137-146
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• 2012

Dipsaci Radix (Dipsacaceae) has been used as a tonic, an analgesic, anti-inflammatory and anti-complement agents in traditional herbal medicine for the therapy of low back pain, knee pain, rheumatic arthritis, traumatic hematoma, and bone fractures. A high-performance liquid chromatography-electrospray ionization-mass spectrometric method (HPLC-ESI-MS) was developed for the simultaneous quantitation method of the five compounds from the herbal drug: asperosaponin VI and asperosaponin XII (terpene glycosides), sweroside, loganin and dipsacus A(iridoid glycosides). HPLC separation of the analytes was achieved on a C18 column ($150{\times}2.0$ mm i.d., 5 ${\mu}m$) using the aqueous methanol containing 5 mM ammonium acetate with gradient flow of the mobile phase. Detection of the analytes was performed by positive ion electrospray ionization, and selected ion monitoring was used for data acquisition using m/z corresponding molecular adduct ion, $[M+NH_4]^+$ and $[M+H]^+$. Calibration graphs showed good linearity ($r^2$=0.9997) over the wide range of the analytes; intra- and inter-day precisions (RSD, %) were within 9.1% and the accuracy between 94.0-111.0%. Recoveries of the analytes through the assay procedure were in the range of 93.7-110.8%. Analytical results of the herbal drugs of Dipsaci Radix (17 samples) show wide distribution of the five marker compounds and clear difference of the species from Phlomidis Radix (4 samples). The developed method would provide a practical guide for the quality control of the herbal drug.