• 대한족부족관절학회지
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• 제15권2호
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• pp.86-91
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• 2011

Purpose: To evaluate the effectiveness as well as correct the post-traumatic severe ankle equinus deformity by conducting the treatment surgery, which is divided into 2 stages, soft tissue adhesiolysis and ankle arthrodesis. Materials and Methods: We have conducted the methods, which are Z-plasty Achilles tendon lengthening, multiple capsulotomy and tendon lengthening (flexor hallucis longus muscle, flexor digitorum longus, posterior tibialis tendon) for 10 patients who has shown equinus deformity after post-traumatic compartment syndrome due to the injury. The average age of patients was 33.7 year-old; there were 8 men and 2 women, and the follow up period was 13 months (6~31 mon). Outcomes were rated based on American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Visual Analogue Scale (VAS) and patient's satisfaction after operation. Results: The average degree of preoperative equinus deformity was 64 degree (-60~-70), and we've obtained AOFAS anklehindfoot score that was evaluated after 4 months of 2nd operation which was 76.7 score on average. We've also checked the decreased pain score from all of the patients according to the fact that the average VAS before the surgery was 6 (4~8), but it reduced to 3 (1~4). The patient's satisfaction showed generally great satisfactions which was 5 cases were excellent, 2 cases were good, and 3 cases were fair. Conclusion: The two staged surgical treatment of post -traumatic severe ankle equinus deformity, which was conducted of soft tissue adhesiolysis and arthrodesis, could be one of the effective methods to improve patients walking ability.

• 대한족부족관절학회지
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• 제13권1호
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• pp.14-18
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• 2009

Purpose: We evaluated the results of treatment and clinical symptoms of 11 cases of synovial chondromatosis in the ankle joint. Material and Method: From February 2001 to May 2008, 11 cases with synovial chondromatosis involving ankle joint underwent surgical treatment. There were 5 males and 6 females. The average age at surgery was 51 years. The average follow-up period was 42 months. Duration from onset of symptom to treatment was 117 months. Chief complaints of patients, 9 cases were pain and 1 case was mass like lesion, 1 case was found on x-ray. Preoperatively, all cases were evaluated on simple x-ray, 4 cases on CT, 4 cases on MRI and 1 case on ultrasonogram. 10 cases underwent synovectomy and loose body removal. 5 cases of 10 cases underwent open synovectomy and loose body removal and arthrosocpic surgery. 4 cases of 10 cases underwent only open synovectomy and loose body removal and 1 case of 10 cases underwent only arthroscopic surgery. 1 case underwent tibiotalar arthrodesis. Results: The location of loose bodies was 7 cases on posterior and 4 cases on anterior and 4 case on lateral and 3 cases on multiple site. Postoperatively, all patients showed marked clinical improvement and had subjective satisfaction except reoperation 2 cases and arthrodesis 1 case. AOFAS score of all patients was average 82.2. Conclusion: Clinical results of the synovial chondromatosis of ankle joint were satisfactory. More accurate preoperative evaluation is required to achieve prevention of postoperative recurrence and better outcome.

• Journal of Korean Neurosurgical Society
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• 제39권4호
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• pp.251-255
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• 2006

Objective : To determine the clinical and radiological safety of 15 consecutive patients managed with plate and screw fixation systems applied to the cervical lateral mass. Methods : 15 patients who underwent posterior cervical and T1 arthrodesis were reviewed from Jan 2002 to Dec 2004. Posterior cervical screw and plate fixation was applied on the lateral mass of the cervical spine. The authors have tried lateral mass screw fixation using a modified Magerl's technique [$20^{\circ}$ lateral and $20{\sim}30^{\circ}$ rostral screw trajectory] under preliminary radiological study. The average patient age was $39.73^{\circ}{\pm}11.00\;years$, and the average follow-up period was $9.73^{\circ}{\pm}6.77\;months$. Computed tomography scans taken after surgery were reviewed to confirm the attempted screw trajectory correct and safety. Results : Three of 93 lateral mass screws were malpositioned but clinical damage was not noted. Two of 8 pedicle screws on the T1 vertebrae were not placed on the correct pedicle area. Screw and plate loosening was observed in one case but was not subjected to an additional procedure because of maintained screw position observed during follow-up periods. Conclusion : The results of this study indicate that lateral mass screw fixation using the Modified Magerl's technique on the cervical lateral mass may provide safe and effective application on the patients. In addition, the chance of incorrectly placed screws was higher in T1 pedicle screw fixation than in lateral mass screw fixation of the cervical area.

• 대한정형외과학회지
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• 제54권1호
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• pp.37-44
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• 2019

목적: 슬관절 주위 악성 골연부 종양 치료 시 종양의 도약전이나 슬관절 내 침범, 종양인공관절 치환술 후 반복적 감염 치료를 위한 인접골 절제, 국소재발 및 기계적 파괴가 발생한 경우 슬관절 상하부 전치환술은 하지와 슬관절 기능을 보존하는 한 방법이다. 이 중 반복된 감염 치료를 위해 슬관절면 반대측 골까지 절제 후 한시적 슬관절 고정술을 한 환자에서 가동관절로 재치환술 시 적응증, 합병증, 치환물의 생존율에 대하여 알아보고자 하였다. 대상 및 방법: 본 연구는 슬관절 상하부 전치환술 환자 34예 중 슬관절 주위 종양인공관절 치환술 후 반복적인 감염으로 슬관절면 반대측 골까지 절제한 후 한시적 슬관절 고정술이 불가피했던 13예를 대상으로 하였다. 진단, 원발병소의 위치, 슬관절 상하부 전치 환술을 받기 전까지 수술 횟수 및 기간, 재 재건술 후 치환물의 생존율, 합병증, 기능적 결과를 분석하였다. 결과: 슬관절 상하부 종양인공관절 치환물의 Kaplan-Meier 법에 의한 5, 10년 생존율은 각각 69.0%±12.8%, 46.0%±20.7%였다. 총 13예 중 6예(46.2%)에서 주 합병증이 발생하여 3예는 내고정물을 제거 후 슬관절 고정술을, 2예는 내고정물의 부분교체를, 나머지 1예는 감염된 육아조직만 제거하였다. 최종 추시상 가동관절을 유지한 10예의 Musculoskeletal Tumor Society 기능평가 점수는 평균 24.6점(21-27점)이었다. 슬관절 상하부 종양인공관절 치환술이 실패하여 슬관절 고정술로 재치환 한 3예의 기능평가 평균 점수는 12.3점(12-13점)이었다. 가동관절을 유지한 10예의 슬관절 가동 범위는 평균 67°였다(0°-100°). 슬관절 능동적 신전제한은 평균 48° (20°-80°)였다. 결론: 슬관절 주위 종양인공 치환술 후 반복적인 감염으로 슬관절면 반대측 골까지 절제 후 한시적 슬관절 고정술이 불가피했던 환자에서 슬관절 상하부 종양인공관절 치환술은 합병증의 위험성은 높으나 슬관절 고정술에 비해 기능적 결과가 월등하므로 시도할 가치가 있는 술식이다. 고정된 슬관절을 가동관절로 치환 시 반흔 조직을 철저히 제거하고 연부조직을 확보하여 종양인공관절을 삽입 후 굴곡 및 신전이 가능할 정도의 공간을 확보하는 것이 술식의 성공에 중요하다고 생각된다.

• 한국전산구조공학회:학술대회논문집
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• 한국전산구조공학회 2009년도 정기 학술대회
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• pp.283-286
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• 2009

척추경 나사못을 이용한 요추 유합술은 가장 보편적으로 사용되어지는 수술적 치료 방법이다. 과거 여러 연구들에서 이러한 척추 유합술의 임상적 우수성은 이미 입증 되었으며, 척추경 나사못은 시술 부위의 운동을 완전히 제한함으로써 높은 유합율을 얻을 수 있으나, 상대적으로 인접 분절의 조기 퇴행성 변화의 요인 중 하나로 보고되고 있다. 따라서 본 연구에서는 유한요소해석 방법을 이용하여 척추경 나사못 시술에 따른 척추체의 운동범위 및 인접 분절 추간판의 스트레스 증가량을 계산하였고, 척추경 나사못 모델과 유합 후 나사못 제거에 따른 모델 또 시술하기 전 정상모델과 비교하여 생체 역학적 측면에서 분석하여 척추경 나사못을 이용한 요추 유합술 후, 척추경 나사못의 제거의 임상적 효과와 그 이론적 근거를 제시하고자 한다.

• 대한족부족관절학회지
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• 제17권3호
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• pp.234-238
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• 2013

Osteoarticular tuberculosis is often misdiagnosed as other disease because of a rare incidence and nonspecific clinical and radiographic presentation. Therefore, it is important to know clinical and radiographic presentations of osteoarticular tuberculosis and to diagnose in early phase. Especially, fistula formation is one of the most important clinical features which suspects osteoarticular tuberculosis. We report a case of ankle tuberculosis to be misdiagnosed as subtalar osteoarthritis and performed subtalar arthrodesis.

• Journal of Korean Neurosurgical Society
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• 제41권4호
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• pp.264-266
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• 2007

Atlantoaxial facet joint osteoarthritis is rare, often undiagnosed because it may be misdiagnosed as occipital neuralgia, or degenerative cervical spondylosis. Unilateral occipitocervical pain aggravated by head rotation is a specific symptom. Conservative treatment is usually effective. But when the patient complains of intractable neck pain localized to occipitocervical junction and unresponsive to medical therapy, surgical treatment should be considered. Though a few reports of surgically treated atlantoaxial osteoarthritis has been published, surgical outcome is favorable. A case of a surgically treated atlantoaxial osteoarthritis is presented with a review of the literatures.

• Journal of Korean Neurosurgical Society
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• 제41권1호
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• pp.61-64
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• 2007

Lumbo-sacral junction is a transition lone between the mobile lumbar spine and immobile pelvis. Lumbosacral junction has been considered to be the most troublesome portion of the spine to be fused because of the difference in anatomical and biomechanical factors between spine and pelvis. A metastatic sacral tumor in a 57-year-old man was resected, followed by unilateral lumbo-iliac fixation across lumbosacral junction using modified Galveston technique. Rigid fixation was successfully achieved. Detailed anatomy and surgical techniques are presented.

• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2006년도 춘계학술대회
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• pp.211-211
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• 2006

• 대한족부족관절학회지
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• 제6권1호
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• pp.96-99
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• 2002

There are many reports on the various methods of treatment for hallux valgus. 1st metatarsal proximal osteotomy with distal soft tissue procedure or 1st metatarsophalangeal joint arthrodesis has been conventionally used for treatment of severe hallux valgus. We performed a new double chevron osteotomy in 3 cases and obtained satisfying results. We present this procedure as a new method of treatment for severe hallux valgus.