• 대한정형외과학회지
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• 제53권6호
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• pp.459-465
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• 2018

정형외과 수술의 임상적 결과에 영향을 미치는 요소는 여러 가지가 있지만 수술적 수기가 가장 중요한 요인이며 로봇공학은 술기를 보다 정확하고 일관되게 수행하기 위해 도입되었다. 정형외과 영역에서는 20년 전부터 로봇수술을 사용하였으나 실용성 문제와 합병증의 발생으로 일부 로봇은 도태되었으며 단점을 개선한 로봇이 소개되고 있다. 대부분의 로봇수술은 인공관절수술 분야에서 시행되었고 치환물의 정렬과 위치 선정에서 우수한 것으로 보고되고 있다. 그러나 임상적 결과의 우수성, 실용성, 가성비 등의 측면에서 제한점이 있고 일부 로봇수술에서는 합병증 발생 빈도가 높다는 보고가 있었다. 초기 로봇수술은 수술자의 개입 없이 계획된 수술이 진행되는 능동형 로봇수술이 주를 이루었으나 최근에는 수술과정에서 실시간 피드백을 통해 술자가 술 전 계획을 변경할 수 있고, 햅틱 경계 내에서 제한된 골절제를 함으로써 주요 혈관, 신경, 인대 등의 손상을 최소화할 수 있는 반능동형 로봇수술이 소개되고 있다.

• 대한족부족관절학회지
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• 제10권2호
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• pp.201-206
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• 2006

Purpose: To evaluate the advantages of the antiglide plate fixation procedure for Danis-Weber type B lateral malleolar fractures of ankle compared to other methods of lateral plate fixation. Materials and Methods: We reviewed 70 cases that antiglide plate fixation and lateral plate fixation procedures were performed from Mar. 2001 through Mar. 2006. Of the total 70 cases, they were divided into two groups ; 22 cases were treated with the antiglide plate procedure (Group I) and 48 cases were treated with the lateral plate procedure (Group II). The results of the two groups were analyzed both radiographically and clinically using Ankle-Hindfoot scale of the American Orthopedic Foot and Ankle Society (AOFAS). Results: All fractures were healed at average of 8 weeks both radiographically and clinically. According to the Ankle-Hindfoot scale, all cases of Group I and 48 cases of Group II were above 80 points. 2 cases (9%) in Group I complained of peroneal tendinitis, while 19 cases (39%) in Group II showed skin irritation resulting from the screw or the plate. A total of 6 cases (27%) in Group I and 27 cases (55%) in Group II complained cosmetic problems. Conclusion: we concluded that the antiglide plate fixation for Danis-Weber type B lateral malleolar fractures is one of the good methods. But, further analysis will be need to find a solution for the peroneal tendinitis.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2002년도 아시아견관절학술대회
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• pp.349-350
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• 2002

• 대한정형외과스포츠의학회지
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• 제1권1호
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• pp.102-107
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• 2002

목적 : 견관절 불안정성의 관절경적 수술로 재발의 가능성이 높은 환자에 대해견갑하근 및 관절낭 수평 분할을 이용한 하방관절낭이동술을시행하고이에대한결과를분석하고자하였다. 대상및방법 : 1994년부터 1999년까지수술을시행한환자중1년이상추시(평균: 2년, 범위: 1$\~$3년)가가능한 15례를대상으로하였다. 남자가13례여자가2례이었으며평균연령은27 이었다. 질환은다방향성불안정성4례, 수의성불안정성3례, 골성Bankart 병변이있는전방불안정성2례, 접촉성운동선수의전방불안정성6례였다. 13례는관혈적봉합술과하방관절낭이동술을 동시에 시행하였고, Bankart 병변이없던2례는하방관절낭이동술만 시행하였다. 관절낭중첩 정도는평균 19 mm (범위: 10$\~$5 mm)였다. 결과 : 14례에서우수혹은양호의결과를보였으며술후1례에서아탈구되었고, 1례에서전방염려검사에양성소견을보였다. 술후전방거상과팔을체간에붙인외회전, 90$^{\circ}$ 외전에서의외회전의운동범위는술전과통계학적인차이가없었다. 결론 : 견갑하근및관절낭수평분할을이용한하방관절낭이동술은관절운동범위의감소없이과잉관절낭과Bankart 병변을치료할수있어관절경적치료로재발의가능성높은환자에서권장될치료법으로사료되었다.

• 대한족부족관절학회지
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• 제19권2호
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• pp.47-50
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• 2015

Microfracture procedure has been widely recognized as the primary surgical treatment for an osteochondral lesion of the talus. However, if symptoms persist after initial surgery, selection of a secondary procedure can be difficult. The author desciribes the advantage and value of autologous osteochondral transplantation as a secondary procedure after failed microfracture for osteochondral lesion with a review of sevral previous published articles.

• 대한족부족관절학회지
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• 제26권4호
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• pp.171-176
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• 2022

Purpose: This study reports on a series of patients with chronic lateral ankle instability that underwent the Brostrom procedure with suture tape augmentation and allowed early unrestricted weight-bearing in a simple stirrup brace. Materials and Methods: This retrospective study was conducted on 36 patients (22 males and 14 females of mean age 34 years [range 23~48 years]) with chronic lateral ankle instability treated using the Brostrom procedure using suture tape augmentation and inferior extensor retinaculum reinforcement with a fiber-wire connected to a SwiveLock screw inserted into the talus. When possible, patients started unrestricted weight-bearing in a stirrup brace from the third postoperative day. Demographics and functional outcomes, including American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot, visual analogue scale (VAS), and satisfaction scores, were recorded. In addition, varus stress radiographs obtained before and 24 months after surgery were compared. Patients were followed for a mean 29 months (range 25~40 months). Results: Mean AOFAS ankle-hindfoot scores increased from 51 points preoperatively to 92 points at final follow-up, and mean VAS decreased from 6.8 to 1.2 points. Mean patient satisfaction scores were 8.7 at 12 months and 9.6 at 24 months. Stress radiographs demonstrated that talar tilt decreased from a mean 18 degrees preoperatively to 7 degrees at 24 months. Conclusion: Early unrestricted weight-bearing in a stirrup brace following the Brostrom procedure with suture tape augmentation is a successful protocol for treating chronic lateral ankle instability.

• Archives of Reconstructive Microsurgery
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• 제9권1호
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• pp.80-87
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• 2000

Acute high speed accidents that results in full thickness skin defect and exposure of tendon, nerve, vessel and periosteum over denuded bone demands soft tissue coverage. Exposed bone often ensues chronic infection and requires free flap transplantation which surely covers defects in one stage operation and enhances transport of oxygen-rich blood and converts a non-osteogenic or partially osteogenic site into a highly osteogenic site, but exposed bone which had performed free flap transplantation sometimes necroses and needs secondary bone procedure. Scar contracture limits joint motion should be excised and covered with normal soft tissue to restore normal range of motion. Authors have performed the large latissimus dorsi myocutaneous free flap in 8 cases of extensive soft tissue defect and exposed bone lesion in the leg and 1 case of the flap was failed. The secondary ilizarov bone procedure was performed in 3 of 8 cases. 2 cases of large burn scar contracture and 1 case of posttraumatic scar contracture in lower extremity were restored with the large latissimus dorsi myocutaneous free flap. Authors concluded that large latissimus dorsi myocutaneous free flap is the most acceptable microvascular procedure in large soft tissue defect combined with exposed periosteum and bone requiring secondary bone procedure and in large burn scar contracture limiting knee joint motion.

• 대한골관절종양학회지
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• 제1권1호
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• pp.52-59
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• 1995

Metastatic cancer is the most common tumor of the skeleton. The prevalence of pathologic fracture may increase as patient survival is prolonged by improved cancer therapy. With recent advances in orthopaedic procedure and medical management of terminal cancer patients, it is generally agreed that aggressive treatment should be undertaken for patient with pathologic fracture secondary to metastatic disease, and a team approach should be utilized. The authors have reviewed twenty cases of pathologic fracture of the long bone due to metastatic tumor treated in the Department of Orthopedic Surgery, Yonsei University College of Medicine, from April 1989 to April 1994 and the following results were obtained. 1. The mean age at surgery was 58.4 years (ranged from 24years to 86years) and among 20 cases, 10 cases were male and the others were female. 2. The most frequent site of pathologic fracture in long bone is femur(15 cases, 75%), and followed by humerus(4 cases, 20%), tibia(1 case). 3. The frequently encountered primary tumors that metastases to long bone are those of the lung(7 cases, 35%), breast(4 cases, 20%), and prostate(2 cases, 10%). 4. The operative procedure was performed by resection of the tumor mass extensively, and we used polymethylmetacrylate for filling the dead space after resection, in all cases. 5. The mean survival period after operation is 9.2 months(ranged from 1 month to 4 years and 9 month). 6. The results of postoperative pain relief status were graded as fair to excellent in 17 cases(85%).

• Archives of Reconstructive Microsurgery
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• 제2권1호
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• pp.70-76
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• 1993

The authors analyzed the clinical results of the reconstructive surgery for injured hands and feet due to frostbites and electrical burn with microsurgery in 7 patients, 12 cases at the department of orthopaedic surgery, school of medicine, Kyung Hee university from Jan. 1989 to Jul. 1992, and the results were as foollowings. 1. The age at the time of injury was av 24.6 yrs ranging from 4 to 35 yrs, and all cases were male. 2. The follow up period was av. 24.4 Mo ranging from 12 Mo. to 56 Mo. 3. The causes of injury were frostbite in 9 cases, electrical burn in 2 cases. 4. Initial operative treatment was performed av. 69.3 days ranging from 2 to 210 days. 5. For the reconstructive procedure, scapular free flap was applied in 6 cases, radial forearm flap in 4, dorsalis pedis 1ffap in 1, neurovascular island flap in 1. 6. Among total 12 cases, there were 5 cases(41.7%) of wound infection and 3 cases (25.0%) of partial necrosis of donor flap. 7. In 11 cases(90.1%), the end result was satisfactory. In the analysis of above results the reconstruction with microsurgery is effective procedure for reconstruction of Injured hand and foot due to frostbite and electrical burn.

• 대한족부족관절학회지
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• 제15권3호
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• pp.139-143
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• 2011

Purpose: The purpose of this study was to introduce the 'Matrixplasty' for the treatment of a severely incurved toenail with growth plate deformity and to report our results treating this disease entity. Materials and Methods: Between January 2010 and May 2010, 48 consecutive patients (62 cases) underwent treatment of symptomatic incurved toenails with the 'matrixplasty'. The mean period of time at last follow-up was $14.0{\pm}1.3$ months. The recurrence rate and complication rate were evaluated. An American Orthopedic Foot and Ankle Society (AOFAS) forefoot hallux score was assigned and patients were evaluated at pretreatment and the last follow-up meeting. For evaluation of improvement in toenail shape, the center to edge angle of the toenail was measured at pretreatment and last follow-up. Results: All ingrown toenails healed and the nail deformity was corrected within 3 weeks after the procedure. Among the 62 cases, four cases had recurred by the last follow-up. The mean pretreatment AOFAS forefoot hallux score was $73.1{\pm}12.8$, and it improved to $98.7{\pm}1.1$ by the last follow-up (p<0.01). The mean center to edge angle of the toenail improved from $53.3{\pm}12.9$ degrees to $18.2{\pm}7.4$ degrees by the last follow-up (p<0.01). Minor paronychia, which was managed with local wound dressing and oral antibiotics, was identified in eight cases. Conclusion: Matrixplasty showed excellent clinical results in the treatment of severe incurved toenail (pincer nail) and this procedure also showed great improvement of the deformed toenail and its growth plate.