• 제목/요약/키워드: orthopedic treatment

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당뇨 합병증으로 인한 하지 절단술의 위험 인자의 포괄적 분석 (Comprehensive Analysis for Risk Factors of Lower Extremity Amputation as a Treatment of Complicated Diabetic Foot)

  • 정형진;배서영;민병권;박재구;감민철;최지원
    • 대한족부족관절학회지
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    • 제16권4호
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    • pp.257-264
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    • 2012
  • Purpose: The diabetic foot lesions are intractable, and aggravation often leads to amputation. None or minor amputation group was treated debridement or toe amputation and major amputation group was treated Ray, Lisfranc, Chopart, Below Knee and Above Knee amputation. We investigate the risk factors for major limb amputations among patients with diabetic foot lesion. Materials and Methods: The subjects were 73 diabetic foot lesion patients (83 diabetic foot lesions) treated at our department from January 2006 to December 2010. Non or Minor amputation group of 44 cases were treated with debridement or toe amputation. Major amputation group of 39 cases were treated with Ray, Lisfranc, Chopart, below or above Knee amputation. We investigated socioeconomic factors, diabetes mellitus related factors and wound related factors and laboratory factors. Statistical analysis was done by Students t-test, Chi-square test, Mann-Whitney's U test. Results: In our analysis, wound size, wound classification (Wagner classification, Brodsky classification), white blood cell counts, polymorphoneuclear neutrophil percentage, hemoglobin, C-reactive protein and albumin were risk factors for major amputation (p<0.05). Conclusion: Low education level, nutritional condition, premorbid activity level and progressed wound condition were observed in major amputation group compared with non or minor amputation group. In the major amputation group, higher white blood cell count, C-reactive protein level and lower albumin level were observed. Together with maintenance of adequate nutritional condition, early detection of lesions and foot care for early treatment is important. Therefore, active investigation with full risk evaluation of vascular complication is also important.

척추에 발생한 거대세포종의 수술적 치료 (Surgical Treatment of the Giant Cell Tumors in the Spine)

  • 강용구;이인주;장한;권순용;유기원;이상훈
    • 대한골관절종양학회지
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    • 제4권1호
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    • pp.37-43
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    • 1998
  • Between 1992 and 1996, 5 patients with the giant-cell tumor of the spine were treated. Four were female and one was male. The mean age was 34 years old, and the mean follow-up time was 36 months. The locations of the lesions were the cervical spine in 1, the thoracic spine in 3, and the lumbar spine in 1. Pain was the predominant presenting symptom in all cases and four had a neurological deficit. A combined anterior and posterior surgical approach wds as performed in all cases, which were also treated with AIF(anterior interbody fusion) and anterior and/or posterior instrumentation. Adjuvant radiation therapy was performed in 1 case of cervical spine. At the final follow-up, the pain and neurologic symptoms were improved. Radiologic examination showed no evidence of local recurrence and no failure of instrumentation of the spine.

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족부에 발생한 활막 연골종증을 동반한 유선상 과오종: 2예 보고 (Melorheostosis with Synovial Chondromatosis of the Foot: A Report of Two Cases)

  • 이채칠;김상우;최혜정;황일영;김민석
    • 대한족부족관절학회지
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    • 제19권4호
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    • pp.193-196
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    • 2015
  • Melorheostosis is a rare disease, belonging to the sclerotic bone dysplasia group. Initially described by Leri and Joanny in 1922, its etiology remains unknown. Onset is usually insidious, with deformity of the extremity, pain, limb stiffness, and limitation of motion in the joints. The typical radiographic appearance consists of irregular hyperostotic changes of the cortex, resembling melted wax dripping down one side of a candle. Treatment is usually symptomatic and conservative; however, conservative treatment is unsatisfactory due to functional issues when involving the distal extremity. We report on two cases of melorheostosis with synovial chondromatosis of the foot treated by mass excision.

상완골 과상부 골절후 발생한 내반주 변형에 대한 삼차원 교정 절골술 (Three-Dimensional Corrective Osteotomy for Treatment of Cubitus Varus after Supracondylar Fracture of the Humerus)

  • 김풍택;인주철;경희수;오승훈
    • Clinics in Shoulder and Elbow
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    • 제1권1호
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    • pp.58-65
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    • 1998
  • Cubitus varus deformity after supracondylar fracture of the humerus in children generally includes deformities of varus, hyperextension and internal rotation. Recently almost all corrective osteotomies for treatment of the varus deformity have been limited to correction of only the varus or of the varus and hyperextension deformity. Electromyographic study has revealed unphysiological joint motion and muscle activity around the joint in elbows with cubitus varus, hyperextension and internal rotation deformity. On this basis we have successfully attempted simultaneous correction of all three deformities. The end results in ] 3 elbows have been satisfactory without any complications such as delayed union, limitation of elbow motion or nerve palsy. In conclusion, we recommend simultaneous correction of the three elements of cubitus varus deformity to restore anatomic alignment of the elbow joint.

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거골의 골연골 병변의 관절경적 치료 (Arthroscopic Treatment of the Osteochondral Talar Lesion)

  • 김성재;권세광;강응식;이진우
    • 대한족부족관절학회지
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    • 제6권1호
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    • pp.28-34
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    • 2002
  • Purpose: The purpose of this study was to evaluate outcome of ankle arthroscopy with high anteromedial and anterolateral portals for osteochondral talar lesion. Materials and Methods: A prospective study was conducted between March 1992 and January 2000 by one surgeon. Total 48 patients who had osteochondral talar lesion were included. Using high anteromedial and anterolateral portals, arthroscopic treatment was performed. A functional evaluation was performed with the Karlsson scoring scale. Results: Of the 48 patients, 28 cases had anterolateral talar lesion and 18 cases had medial talar lesion and 2 cases had central lesion. The 42 cases(87.5 %) had trauma history. On Karlsson scoring scale, anterolateral talar lesion was better than medial talar lesion(p=0.035). Conclusion: Using high portals, we could get better visualization of talar dome and posterior chamber of ankle, and do some limited procedures without additional portals. Osteochondral lesions were treated successfully only when they were traumatically induced and localized without diffuse chondromalacia of talus and tibia.

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발목관절의 미만형 색소 융모 결절성 활액막염에서 관절경적 및 개방적 활액막 절제술을 이용한 수술적 치료: 증례 보고 (Surgical Treatment for Diffuse Pigmented Villonodular Synovitis of the Ankle by A Combined Open and Arthroscopic Synovectomy: A Case Report)

  • 최준철;송우석;변찬웅;김진;한은미
    • 대한족부족관절학회지
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    • 제23권3호
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    • pp.139-142
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    • 2019
  • Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving the synovial membranes. Complete excision with a total synovectomy is important for diffuse type PVNS because of its high recurrence rate. In the ankle, complete excision of diffuse type PVNS is difficult due to the anatomical structure of the ankle joint. This paper reports the author's experience of surgical treatment with combined open and arthroscopic synovectomy. In this manner, it is expected that the complications of the open procedure and the recurrence rate of arthroscopic procedure can be reduced.

원위 유경 피판(distant pedicled flap)은 아직도 수부 재건에 유용한가? (Is the Distant Pedicled Flap Still Useful in Reconstruction of the Injured Hand?)

  • 최수중;권봉철;이용범;안희찬
    • Archives of Reconstructive Microsurgery
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    • 제17권2호
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    • pp.61-67
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    • 2008
  • Introduction: The purpose of this study is to evaluate the necessity of distant pedicled flap in the treatment of soft tissue defects in the hand. Materials and Methods: Distant pedicled flap was performed in the 25 hands of 25 patients from 2000 to 2004. There were 20 males and 5 females and mean age was 34 years. The surgery was done for electrical burns in 13 patients, flame burns in 8 patients and crushing injuies in 4 patients. Results: We have performed 25 distant pedicled flaps for the coverage of soft tissue defects in the hands when local and free flaps were unavailable. Soft tissue coverages by distant pedicled flap were completely successful in all the 25 hands. No complication such as total flap loss, marginal flap loss and infection occurred. Conclusion: Distant pedicled flaps were very useful alternative method in the treatment of soft tissue defect in the hand.

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단일엽 회전 피판술을 이용한 당뇨병성 전족부 궤양의 치료: 5예 보고 (Treatment Using a Single-Lobed Rotation Flap in Diabetic Forefoot Ulceration: Five Case Reports)

  • 김준범;이봉주;김철우;정덕희
    • 대한족부족관절학회지
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    • 제23권4호
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    • pp.208-211
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    • 2019
  • Diabetic foot ulcers can progress to the point where amputation is needed, and so these ulcers require active treatment. Skin grafts or flaps can be performed for coverage of this type of ulcer. Local flap surgery is relatively easy to perform and good results have been previously reported. We performed single-lobed rotation flap on 5 cases of forefoot ulcer around the site of weight bearing. The location of the foot ulcers was the medial part of the first metatarsophalangeal joint in all the patients. The mean size of the defect was 4.70 ㎠. Managing of ulcers, controlling of diabetes and infection, and improving of peripheral blood flow were performed before surgery. In two cases, infection progressed to the articular cartilage and so metatarsophalangeal joint fusions were performed simultaneously. All the cases were completely transplanted. There was no recurrence of the ulcers, and all the patients were able to walk.

Complications of reverse shoulder arthroplasty: a concise review

  • Kim, Su Cheol;Kim, Il Su;Jang, Min Chang;Yoo, Jae Chul
    • Clinics in Shoulder and Elbow
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    • 제24권1호
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    • pp.42-52
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    • 2021
  • Reverse shoulder arthroplasty is an ideal treatment for glenohumeral dysfunction due to cuff tear arthropathy. As the number of patients treated with reverse shoulder arthroplasty is increasing, the incidence of complications after this procedure also is increasing. The rate of complications in reverse shoulder arthroplasty was reported to be 15%-24%. Recently, the following complications have been reported in order of frequency: periprosthetic infection, dislocation, periprosthetic fracture, neurologic injury, scapular notching, acromion or scapular spine fracture, and aseptic loosening of prosthesis. However, the overall complication rate has varied across studies because of different prosthesis used, improvement of implant and surgical skills, and different definitions of complications. Some authors included complications that affect the clinical outcomes of the surgery, while others reported minor complications that do not affect the clinical outcomes such as minor reversible neurologic deficit or minimal scapular notching. This review article summarizes the processes related to diagnosis and treatment of complications after reverse shoulder arthroplasty with the aim of helping clinicians reduce complications and perform appropriate procedures if/when complications occur.

하지 외측 구획에 국한된 구획 증후군에서 수술적 치료와 보존적 치료 간에 비교: 증례 보고 (Comparison between Surgical and Conservative Treatments in Isolated Lateral Compartment Syndrome of the Lower Leg: A Case Report)

  • 곽희철;서영채;정수환;김대유
    • 대한족부족관절학회지
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    • 제26권3호
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    • pp.136-142
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    • 2022
  • Lateral compartment syndrome of the lower leg is rarely observed. Hence, there may be difficulty in diagnosis as its clinical patterns are different and more complicated than usual. We report two rare cases of a 20-year-old and a 28-year-old diagnosed with isolated lateral compartment syndrome who had either a surgical or conservative treatment. The comparison was done by analyzing the progression of neurological manifestation, electromyography, and nerve conduction study for two years. In the final follow-up, the patient who underwent the surgical treatment showed a shorter recovery time. However, both patients showed a full recovery from neurologic deficits.