비수술적으로 치료한 결절종에 의한 상견갑 신경의 포착 증후군

이충길(Choong Gil Lee),권진우(Jin Woo Kwon),박재흠(Jae Hyum Park),이상훈(Sang Hoon Lee),권귀련(Kwi Ryun Kwon),이우세(Woo Se Lee) 대한정형외과학회 1997 대한정형외과학회지 Vol.32 No.3

국소마취하 슬관절경 검사 및 수술

이충길,권진우,손경태,신승호,이우세 대한슬관절학회 1997 대한슬관절학회지 Vol.9 No.1

Local anesthesia for arthroscopic procedure of the knee is an increasingly popular technique that avoids the use of general anesthesia and the associated risks of respiratory depression, aspiration, and postoperative sedation. Many authors, for example McGinty etc., Martin, Yoshiya etc., advocated local anesthesia as safe and efficient method for arthroscopic procedures of the knee. We performed arthoroscopy of the knee under local anesthesia on 150 patients for diagnostic and operative purposes between January l993 and December l996. The technique of local anesthesia that we used was that 20cc of 0.5%; bupivacaine with 1:200,000 epinephrine was injected into superolateral portal of the knee joint and additional 10-20cc ot 1% lidocaine into the arthroscopic portals. Pnevmatic tourniquet was not applied in all cases. We analysed the 150 cases and the results were as follows; The diagnostic arthroscopy was performed in 50 cases and the operative arthroscopy was in 100 cases. The duration of local anethesia was from 4 hours to 12 hours, with an average of 6 hours. In 35 cases arthroscopy was performed as outpatient procedure and average hospital stay excluding other problem was 5 days. No complication related to systemic toxicity by local anesthetics was observed. Conclusively arthroscopy of the knee under local anesthesia is safe and effective procedure to avoid the risks of general anesthesia but patients selection is very important.

활차골화점의 방사선 소견상의 형태

조원호,신승호,김준호,권진우,이우세 대한골절학회 2000 대한골절학회지 Vol.13 No.2

Purpose: The trochlear secondary ossification center may be variable in number, shape and size, thus it can be considered as fracture. The purpose of this study is to evaluate radiographic analysis of normal trochlear secondary ossification center. Method and Material: We reviewed the 100 cases of normal elbow radiographs and classified the numbers and shapes of trochlear sencondary ossification center. Result: The number of trochlear secondary ossification center was that one was 72 cases(72%), two 19 cases(19%), three 9 cases(9%). The shape of trochlear ossification center which has only one ossification center was classified as round was I 1cases(15.3%), elliptical 24 cases(33.3%), irregular 37 cases(51.4%). Conclusion: The radiographic finding of trochlear secondary ossification center is variable in number, size and shape, thus authors concluded that fragmentation or bizzare shape of trochlea in painless elbow must be considered as secondary ossification center.

소절개 및 골찰을 이용한 Hohl 2형과 3형 경골과 골절의 수술적 치료

조원호,김재일,권진우,손경태,이우세,신승호 대한골절학회 1999 대한골절학회지 Vol.12 No.3

Severely depressed plateau fractures, especially Hohl I, III, can not be reduced by ligamentotaxis and require elevation through a cortical window, bone grafting, and fixation with either cancellous screws or a buttress plate. But traditional long lateral parapatellar incision and plate fixation method caused frequent wound dehiscence and deep infection. Thus to reduce the soft tissue problem we treated Hohl II,III plateau fractures by small anterolateral L-shaped incision, submeniscal exposure, reduction of depressed plateau and bone graft through bone window, and then cancellous screws fixation beneath the subchondral bone of elevated plateau. We anayzes 22 cases with Hohl II, III plateau fractures, which were treated by these method from February 1990 to December 1997 and followed more than 1 year. Males were 17, and females were 5. Average age of patients was 44.7 years. The most common cause of injury was traffic accidents (17 cases), and fracture type according to the Hohl' classification was 14 cases of type II, 8 of type III. The associated injuries were 18 cases of meniscus tear, 13 of ligament injury ( 6 ACL, 7 MCL). The clinical results by Blokker s criteria were satisfactory 19 cases(86.3%) and unstisfactory 3 cases(13.7%). We concluded that this method has following advantages; relatively firm fracture fixation, short operation time, low soft tissue problem.

상완골 투구골절 - 2례 보고 -

조원호,신승호,성기호,권진우,이우세 대한골절학회 2000 대한골절학회지 Vol.13 No.4

Spiral fractures of the middle or distal shaft of the humerus that occur during attempts to throw a variety of objects are not common. Many authors have reported that the cause of fracture was the results of uncoordinated muscle violence. We experienced two cases of throwing fractures of humerus, one is baseball player(catcher) preceded by arm pain during throwing motion, the other is recreational hand grenade player without prodromal arm pain.

소아 대퇴골 간부골절에 대한 Ender 정 고정술에 따른 과성장

조원호,박진호,신승호,권진우,이우세 대한골절학회 2000 대한골절학회지 Vol.13 No.1

Purpose: The purpose of this study is to evaluate the leg length discrepancy after Ender nail fixation in children's femoral shaft fracture. Materials and Methods: We reviewed 18 femoral shaft fractures that were treated with Ender nail and studied the relationship between the initial site of fracture, type of fracture and overgrowth. The age of children in this study ranged 6 to 13 years old and the average period of follow-up was 32 months. Results: The range of leg length discrepancy was from 6 mm shortening to 16 mm lengthening and average 3.4 mm lengthening. Only one patient had shortening, nine patients had limbs of equal length(less than 2 mm) and eight patients had lengthening. The average overgrowth was 1.3 mm in proximal 1/3, 7.0 mm in middle 1/3, 3.0 mm in distal 1/3 fractures. The average overgrowth was 7.3 mm in transverse, 1.3 mm in oblique and 2.3 mm in comminuted fractures. Conclusions: We consider closed Ender nailing in children femoral shaft fractures as a good treatment modality in the matter of leg length discrepancy.

경골 골절에 있어서 역동화의 효과

조원호,신승호,성기호,권진우,이우세 대한골절학회 2001 대한골절학회지 Vol.14 No.1

Purpose: The purpose of this study is to evaluate the effect of dynamization which was done for the treatment of delayed union or persisting fracture gap after interlocking intramedullary nailing, by radiographic and physical examination. Materials and Methods: We analyzed 22 cases these were treated with dynamization from 247 cases of tibia shaft fracture treated initially with static interlocking intramedullary nailing from February l990 to May 2000 and were followed up more than lyear. The result of dynamization was classified as 3 groups and we divided each results 3 categories that is effective result, uncertain result and ineffective result. Group A is cases that achived ultimate union with shortening of fracture gap and was 10 cases. Group B is that achieved ultimate union but fracture gap did not reduced and was 10 cases. Group C is that showed ultimate non-union and was 2 cases. Results: The result is that dynamization was effective only 4 cases of group A. 6 cases of group A and 4 cases of group B showed instability(radiolucent halo around nail, hypertrophied callus and leg pain), and 6 cases of group B showed no shortening of fracture gap, thus these were classified as uncertain result. Group C(2 cases) showed non-union, classified as ineffective. Conclusion: Dynamization caused instability in most tibia fractures except simple mid-shaft fracture. So in the comminuted fractures and distal or proximal l/3 oblique fractures, other procedures such as bone graft, refixation should be considered rather than dynamization.

Kirschner 강선 및 철사 고정술을 이용한 쇄골 외측단 골절의 치료

김동현,조원호,김기환,신승호,김준호,권진우,이우세 대한골절학회 2001 대한골절학회지 Vol.14 No.2

Purpose : The purpose of this study is to evaluate the effectiveness of Kirschner wire and additional wire fixation in clavicle lateral end fractures. Materials and Methods: We reviewed 14 cases that were treated by Kirschner wire and wire fixation from January 1997 to May 1999 and followed up for more than 1 year. Average age was 42 years old(male 6, female 8). The fractures were classified according to Jager and Breitner classification: 2 cases of type 1, 5 of type 2a, 5 of type 2b, 2 of type 3. We used 3 types of fixation method: First, interfragment Kirschner wire and wire fixation in simple fracture, Second, first method was reinforced with transacromial Kirschner wire fixation in simple, but osteoporotic bone. Third, fracture was fixed by transacromial Kirschner wire and wire fixation in intraarticular or comminuted fracture. Results: Bony union was obtained in all cases with average duration of 10 weeks. The functional result of shoulder was evaluated by the scoring system of Rowe: exellent 8, good 5, fair 1 case. The complications were pin migration 2, pin infection 1, shoulder LOM 3, traumatic acromioclavicular joint arthritis 2 cases. Conclusion: Appropriate use of three types of Kirschner wire and wire fixation technique according to location of fracture, degree of comminution can improve bony union rate and shoulder function.