대퇴부 손상의 치료

박재형,김형수,김현철,지정민,Park Jai-Hyung,Kim Hyoung-Soo,Kim Hyun-Chul,Ji Jeong-Min 대한정형외과스포츠의학회 2004 대한정형외과스포츠의학회지 Vol.3 No.2

Thigh injuries are relatively uncommon sports injuries. But the incidence is increasing as many kinds of sports activity develops. And the prompt recognition and treatment of these injuries are critical to prevent prolonged disability. Also, despite the simple anatomic structure of the thigh, this region is finely tuned muscular mechanism with both anterior and posterior muscles crossing two joints. So the contracture of thigh muscle can result in not only decreased range of motion of the knee and hip joint, but also painful lumbar spine. So we reviewed recent literatures about the type of thigh injuries, diagnosis, treatment and rehabilitation.

슬관절 전방 십자 인대 파열의 진단에 있어서 KT-2000 기기의 유용성

박재형,김형수,정광규,유정현,Park, Jai-Hyung,Kim, Hyoung-Soo,Jung, Kwang-Gyu,Yoo, Jeong-Hyun 대한관절경학회 2004 대한관절경학회지 Vol.8 No.2

목적: KT-2000 Knee Ligament Arthrometer를 이용하여 정상 슬관절의 전방 전위를 측정하고, 결과에 영향을 미치는 인자들을 알아보며, 전방 십자 인대 손상 환자 슬관절의 전방 전위를 측정하여 이를 바탕으로 정상인의 전방전위 정도를 전방 십자 인대 손상 환자와 비교하여 이 기기의 유용성을 알아 보고자 한다. 대상 및 방법: 슬관절 손상의 과거력이 없는 성인 남자 30명을 대상으로 2명의 검사자가 30lb의 힘으로 슬관절30$^{\circ}$굴곡에서 근육 이완 및 수축, 25$^{\circ}$내회전, 25$^{\circ}$외회전 자세로 전방 전위를 측정하여 두 검사자간의 전방 전위 및 좌우 차이를 비교하였고. 신체 조건에 따라 두 군으로 나누어 각각의 차이에 따르는 전방 전위를 비교하였다 전방십자 인대 손상 환자 30명에서 슬관절을 이완시킨 상태로 3차례 이상 전방 전위 검사를 시행하였다. 결과: 검사자 1의 슬관절 전방 전위는 30$^{\circ}$굴곡 상태로 근육 완전 이완, 근육 수축 상태. 25$^{\circ}$내회전 25$^{\circ}$외회전위치에서 우측 슬관절은 6.5${\pm}$1.5 mm. 2.5${\pm}$0.9 mm, 4.8${\pm}$1.2 mm, 6.4${\pm}$1.3 mm였고 좌측 슬관절은 5.6${\pm}$1.3 mm, 2.1${\pm}$0.8 mm, 4.5${\pm}$1.2 mm, 5.2${\pm}$1.3 mm였으며. 검사자 2는 각각 6.9${\pm}$1.2 mm, 2.9${\pm}$1.1 mm,5.6${\pm}$1.6 mm, 6.9${\pm}$1.5 mm였고, 5.5${\pm}$1.7 mm, 1.9${\pm}$0.9 mm, 5.1${\pm}$1 9 mm, 5.7${\pm}$1.6 mm였으며, 검사자1의 전방 전위 좌우 차는 근육 이완 상태에서 0.9${\pm}$1.0 mm였다. 전방 십자 인대 손상으로 수술을 받은 환자의 전방 전위는 평균 11${\pm}$2.93 mm쳐고, 건측과의 차이는 평균 6.5${\pm}$2.31 mm였다 좌우 슬관절의 비교에서 검사자 1과 2는 30${\pm}$굴곡, 근육 이완시 통계학적으로 좌우차는 있었으나 각각 25례(83%), 21례(70%)에서 좌우 차이가 2mm미만이었고 3 mm이상은 모두 1예에 불과하였으며 근육 이완시 정상인과 전방 십자 인대 파열 환자의 전방 전위 좌우차는 통계학적으로 의미 있는 차이를 보였다. (<0.05) 결론: KT-2000 Knee Ligament Arthrometed의 결과에 영향을 주는 인자는 슬관절 주변 근육의 이완, 슬관절의 굴곡 각도, 경골의 회전. 전위력의 강도, 적용시점, 그리고 키, 체중등의 신체적 요인 등이 있으나 능숙한 기계사용과 정확한 슬관절 위치에서 검사할 때 전방 십자 인대 파열에 대한 진단에 유용한 기구이다. Purpose: In this study, we intended to ascertain the benefit of KT-2000 Knee arthrometer(KT-2000) in the diagnosis of ACL(Anterior cruciate ligament) injury by comparing the anterior displacement of normal knee with that of ACL deficient knee. Materials and Methods: We designated two examiners to measure the anterior displacement of the knee joint of 30 healthy individuals, using KT-2000, at 30$^{\circ}$ flexion setting of muscle full relaxation, contraction, 25$^{\circ}$ internal rotation and 25$^{\circ}$ external rotation and analyzed these results according to the variables and measured the preoperative anterior displacement of the ACL injured knee in the 30 patients who have gone through an arthroscopic ACL reconstruction later. Results: The results of examiner 1 are 6.5${\pm}$1.5 mm, 2.5${\pm}$0.9 mm, 4.8${\pm}$1.2 mm, 6.4${\pm}$1.3 mm in right knee and 5.6${\pm}$1.3 mm, 2.1${\pm}$0.8 mm, 4.5${\pm}$1.2 mm, 5.2${\pm}$1.3 mm in left knee, in order of muscle full relaxation, contraction, 25$^{\circ}$ internal rotation and 25$^{\circ}$ external rotation. The results of examiner 2 are 6.9${\pm}$1.2mm, 2.9${\pm}$1.1mm, 5.6${\pm}$1.6mm, 6.9${\pm}$1.5mm in right, 5.5${\pm}$1.7 mm,1.9${\pm}$0.9 mm, 5.1${\pm}$1.9 mm, 5.7${\pm}$1.6 mm in left knee, The side to side difference of examiner 1 in the setting of muscle relaxation is 0.9${\pm}$1.0 mm. The anterior displaement of ACL injured knee is average 11${\pm}$2.93 mm and difference of average 6.5${\pm}$2.31 mm form that of normal. In comparison between the right and left knees of healthy individuals, the both results of two examiners showed the statistical difference in the setting of muscle full relaxation but, the results showed the side to side difference below 2 mm in 25case(83%), 21case(70%) respectively and above 3 mm in just 1 case. In the comparison between the normal and ACL injured knees, the results show the statistical difference of the side to side difference in the setting of muscle relaxation(p<0.05). Conclusion: The KT-2000 result is affected by relaxation of muscles around knee, flexion angle of knee joint, rotation of tibia, the strength of displacing force, time of the test and physical factors as height and weight. However, the Accuracy of diagnosis of ACL injury by KT-2000 will increase if the examiner is skillful and the tests are made on the exact position of knee joint.

고관절 후방 탈구와 동반된 동측의 대퇴 골두 및 전자 간부 골절

박재형 ( Jai Hyung Park ),김형수 ( Hyung Soo Kim ),정수태 ( Soo Tae Chung ),유정현 ( Jeong Hyun Yoo ),김주학 ( Joo Hak Kim ),차승도 ( Seung Do Cha ),이태우 ( Tae Woo Lee ) 대한골절학회 2010 대한골절학회지 Vol.23 No.1

High-energy injury, as traffic accident or fall down, can cause fracture of femur head and posterior dislocation of hip joint which is accompanied with ipsilateral acetabulum fracture or femur neck fracture. But the case that femur head fracture and posterior dislocation of the hip joint coincide with ipsilateral intertrochanteric fracture of proximal femur is so uncommon that reports of the case is very rare. We hereby are to report the experienced and treated-cases of femur head fracture and posterior dislocation of the hip joint that is accompanied with ipsilateral intertrochanteric fracture.

코드분할 다중접속식 셀룰라/PCS, GSM, W-CDMA RF 수신기 비교 분석

박재형(Jai Hyung Park),신현섭(Hyun Seob Shin),김지훈(Fi Hoon Kim),유형준(Hyung Joun Yoo) 한국통신학회 2000 한국통신학회 학술대회논문집 Vol.2000 No.7

대퇴골 경부 골절에 대한 양극성 인공 고관절 반치환술에서의 실혈량: 위험 인자 분석

박재형 ( Jai Hyung Park ),김형수 ( Hyoung Soo Kim ),유정현 ( Jeong Hyun Yoo ),김주학 ( Joo Hak Kim ),성기혁 ( Ki Hyuk Sung ),김준엽 ( Joon Yub Kim ),박상준 ( Sang Jun Park ),이인혁 ( In Hyeok Lee ) 대한고관절학회 2013 Hip and Pelvis Vol.25 No.2

목적: 고관절 대퇴 경부 골절로 인한 양극성 반 인공 관절 치환술 후 보이지 않는 실혈을 포함한 실질적인 총 실혈량을 계산하여 측정된 실혈량과의 차이를 알아보고 위험 인자가 술 후 실혈량에 미치는 영향을 알아보고자 한다. 대상 및 방법: 2004년부터 2010년까지 본원에서 시행한 대퇴 경부 골절 후 양극성 반 인공관절 치환술을 시행한 환자 356예를 대상으로 하였고 총 실혈량의 계산은 Mercuriali와 Brecher에 의한 공식을 사용하였으며 실혈량에 미치는 위험 인자로 성별, body mass index (BMI), 마취 방법, 심혈관 질환이나 뇌혈관 질환 유무, 술전 빈혈 여부, American Society of Anesthesiologists (ASA) 점수, 시멘트 사용 여부, 항혈전제 사용 여부를 비교 분석하였다. 결과: 계산된 총 실혈량은 1,408±72 ml이고 측정된 실혈량은 980±102 ml로 유의한 차이를 보였고 실혈량과 관련된 위험 인자 중 심혈관 질환이 있을 경우 1,526±369 ml, 전신 마취 시행 시 1,588±279 ml, 비만이 있는 경우 1,645±920 ml, 항혈전제 사용 시 1,605±439 ml로 증가된 결과를 보였다. 결론: 고관절 대퇴 경부 골절 후 양극성 반 인공 관절 치환술시 발생된 총실혈량은 측정된 실혈량에 비해 많은 많은 양이 측정되었으며 수술대상 환자 중 심혈관 질환 및 항혈전제 복용자, 비만 환자, 전신 마취 시에는 수술 시 출혈량을 줄이기 위한 세심한 노력이 필요할 것으로 사료된다. Purpose: We compared visible blood loss and calculated blood loss after bipolar hemiarthroplasty in femoral neck fracture, and evaluated correlation between blood loss and its risk factors. Materials and Methods: A total of 356 patients who underwent bipolar hemiarthroplasty in femoral neck fracture between 2004 and 2010 were enrolled in this study. The total blood loss was calculated using the formula reported by Mercuiali and Brecher. We analyzed several factors, including gender, age, body mass index (BMI), anesthesia method, cardiovascular and cerebrovascular disease, preoperative anemia, American Society of Anesthesiologists (ASA) score, use of cement, and use of antithrombotic agents. Results: Total calculated blood loss(1,408±72 ml) differed significantly from visible blood loss(980±102 ml). In addition, calculated blood loss differed between risk factors(1,526±369 ml in cardiovascular disease, 1,588±279 ml in general anesthesia, 1,645±920 ml in obesity, and 1,605±439 ml in use of antithrombotic agents). Conclusion: Total calculated blood loss was much greater than visible blood loss. Patients with risk factors such as cardiovascular disease, obesity, use of antithrombotic agents, and general anesthesia should be treated with care in order to reduce blood loss.

대퇴 전자간 골절의 금속정을 이용한 내고정술 후 실혈량: 위험 인자 분석

박재형 ( Jai Hyung Park ),정화재 ( Hwa Jae Jung ),신헌규 ( Hun Kyu Shin ),김유진 ( Eugene Kim ),박세진 ( Se Jin Park ),고택수 ( Taeg Su Ko ),박종현 ( Jong Hyon Park ) 대한골절학회 2015 대한골절학회지 Vol.28 No.1

Purpose: We compared visible blood loss and calculated blood loss after intramedullary fixation in intertrochanteric fracture, and evaluated correlation between blood loss and its risk factors. Materials and Methods: A total of 256 patients who underwent closed reduction and intramedullary fixation in femoral intertrochanteric fracture between 2004 and 2013 were enrolled in this study. The total blood loss was calculated using the formula reported by Mercuiali and Brecher. We analyzed several factors, including fracture pattern (according to Evansclassification), gender, age, body mass index (BMI), anesthesia method, cardiovascular and cerebrovascular disease, preoperative anemia, American Society of Anesthesiologists (ASA) score and use of antithrombotic agents. Results: Total calculated blood loss (2,100±1,632 ml) differed significantly from visible blood loss (564±319 ml). In addition, the blood loss of unstable fracture patient was 2,496±1,395 ml and multivariate analysis showed a significant relationship between blood loss and fracture pattern (p<0.01). However, other factors showed no statistically significant difference. Conclusion: Total calculated blood loss was much greater than visible blood loss. Patients with unstable intertrochanteric fracture should be treated with care in order to reduce blood loss.

전하 장골극의 류마토이드 가성낭종(geodes)

박재형 ( Jai Hyung Park ),김주학 ( Joo Hak Kim ),김형수 ( Hyung Soo Kim ),정수태 ( Soo Tae Chung ),유정현 ( Jeong Hyun Yoo ),차승도 ( Seung Do Cha ),이상엽 ( Sang Yeop Yi ),김용훈 ( Yong Hoon Kim ) 대한고관절학회 2008 Hip and Pelvis Vol.20 No.3

Typically, geodes are associated with obvious joint involvement, and they are located in the subchondral portion of the joint. Radiological lucencies are produced by pannus infiltration through a disruption in the subchondral plate, and they present as round or oval cystic areas of various sizes. We report a patient with rheumatoid disease and positive antinuclear antibody who had a geode that did not involve the joint. Considering the mechanism of geode occurrence, this is a very rare report of such a manifestation. As a result, we present a rare case of geode occurrence without joint involvement in the setting of rheumatoid disease.

고관절의 수지상 지방종 -1예 보고-

박재형 ( Jai Hyung Park ),김형수 ( Hyung Soo Kim ),정수태 ( Soo Tae Chung ),유정현 ( Jeong Hyun Yoo ),김주학 ( Joo Hak Kim ),차승도 ( Seung Do Cha ),정진하 ( Jin Ha Jung ) 대한고관절학회 2011 Hip and Pelvis Vol.23 No.1

수지상 지방종(Lipoma arborescens)은 관절낭에서 지방 세포가 활액막의 융모상 지방종을 이루며 이형 증식하는 질환으로 매우 희귀한 질환이다. 비후된 활액막성 지방종이 관절의 움직임에 따라 자극되어 관절의 동통, 삼출, 관절 운동의 제한 및 종창등의 증상을 일으키며 발생 원인으로는 외상, 류마티스 관절염, 염증, 퇴행성 변화 등이 알려져 있으나 명확한 원인은 아직 판명되지 않았다. 대부분의 수지상 지방종은 슬관절 및 주관절등 여러 관절에서의 발생이 보고되고 있으나 고관절에서의 수지상 지방종은 드물어 국내에서는 1예 정도만 보고되고 있다. 저자들은 고관절에 발생한 수지상 지방종 환자 1예를 치료하였기에 문헌고찰과 함께 보고한다. Lipoma arborescens is a very rare disease in which adipocytes form a synovial villous lipoma. In addition, it has the potential for dysplastic proliferation. Hypertrophic synovial lipoma is stimulated by movement of joints, which results in joint pain, effusion, limitation of joint movement and swelling. A definite cause has not yet been proven, but trauma, rheumatic arthritis, inflammation and degenerative change are believed to be possible causes. There have been reports of lipoma arborescens in several joints, including the knee joint and elbow joint. However, it is very rare to find this disease in hip joints. In fact, only one such case has been reported in Korea. We report here on a rare case of lipoma arborescens in the hip joint along with a review of the relevant literature.

W-CDMA 용 RF/Analog 송수신기 설계

박재형(Jai Hyung Park),김지훈(Ji Hoon Kim),유형준(Hyung Joun Yoo) 한국통신학회 2001 한국통신학회 학술대회논문집 Vol.2001 No.7

만성 족관절 외측 불안정성 환자에서의 비골건 병변

김형수 ( Hyung Soo Kim ),정수태 ( Soo Tae Chung ),유정현 ( Jeong Hyun Yoo ),박재형 ( Jai Hyung Park ),김주학 ( Joo Hak Kim ),차승도 ( Seung Do Cha ),오세만 ( Se Man Oh ) 대한스포츠의학회 2010 대한스포츠의학회지 Vol.28 No.2

In patients complained of lateral ankle pain, the peroneal tendinopathy is frequently overlooked because relatively rare. In this study, types of lesion, frequency, and clinical results were analyzed in patients with peroneal tendinopathy associated in chronic ankle instability. This study reviewed the result of 22 patients. The average age was 35.1 years with an average follow-up of 20.1 months. Modified Brostrom procedure was done and peroneal tendon was explored. Peroneal tendinopathy was composed of 9 tear, 2 dislocation, 4 tendinitis, 7 low-lying muscle belly, 1 peroneal quartus. Depending on the type of peroneal tendinopathies, tubularization, groove deepening and retinaculum repair, and debridement were done. All patients had a history of repeated sprains, positive anterior drawer test, lateral ankle pain. After the last follow-up, the visual analogue scale score and American Orthopaedic Foot and Ankle Society score were evaluated. Also, almost of all patients were satisfied and anterior drawer test was improved. If the patients have chronic ankle instability and pain around the retromalleolar area, we keep in mind that the lesions are peroneal tendinopathy.