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서규범(Kyu Bum Seo),남광우(Kwang Woo Nam),유정준(Jeong Joon Yoo),김희중(Hee Joong Kim),김상림(Sang Rim Kim) 대한정형외과학회 2010 대한정형외과학회지 Vol.45 No.2
연골 하 낭종은 양성 낭포성 병변으로 류마티스 관절염이나 퇴행성 관절염에서 종종 관찰된다. 그러나, 선행되는 질환 없이 관절에 발생하는 것은 드물다. 더구나, 상 비구 연골 하 낭성 병변에 발생한 병적 골절은 보고된 바가 없다. 저자들은 상 비구 연골 하 골판의 낭성 병변에 병적 골절이 발생된 44세 여성을 경험하였기에 보고하고자 한다. Subchondral cyst is a benign cystic lesion. and it is often found in patients with rheumatoid arthritis or osteoarthritis. However, its occurrence in those joints without preexisted disease is rare. Furthermore, there has been no report in the medical literature regarding pathologic fracture in the bony plate of a subchondral cyst at the superior acetabulum. We report here on a case of the 44-year-old woman for whom a pathologic fracture was found in the bony plate of a subchondral cyst at the superior acetabulum.
국소 스테로이드 주사 후 자발적으로 발생한 양측 아킬레스건의 파열
신성진 ( Sung Jin Shin ),서규범 ( Kyu Bum Seo ) 대한스포츠의학회 2008 대한스포츠의학회지 Vol.26 No.2
Spontaneous bilateral Achilles tendon ruptures are a rare occurrence that usually occur in patients with chronic systemic disease. Many cases are also associated with corticosteroid or fluoroquinolone use. We present a case of a 66-year-old woman who had bilateral Achilles tendon ruptures after local steroid injection. Intraoperatively, degenerative changes at both sides of rupture end and large defect were seen. We reconstructed the Achilles tendon using V-Y plasty and reinforced the repair site using the flexor hallucis longus tendon for both sides. The patient showed favorable result three years postoperatively with return to range in a degree of activity levels.
이광복 ( Kwang Bok Lee ),서규범 ( Kyu Bum Seo ),강현성 ( Hyun Seong Kang ) 대한스포츠의학회 2011 대한스포츠의학회지 Vol.29 No.1
Calcific tendinitis is most common seen within the rotator cuff of the shoulder, although it may develop around the hip, wrist, elbow, knee, forefoot, and neck. However, there has been no report in the medical literature regarding calcific tendinitis of the common extensor tendon. We present a case of a 26-year-old woman who had calcific tendinitis of the common extensor tendon. Intraoperatively, partial rupture and calcific deposit at the insertion of the common extensor tendon were seen. We were removed calcific deposit and ruptured tissue of common extensor tendon, and then ruptured common extensor tendon was sutured. The patient showed excellent result two years postoperatively with return to range in a degree of activity levels.
Wolter 금속판을 이용한 견봉 쇄골 관절 탈구 및 원위 쇄골 골절의 수술적 치료
김상림 ( Sang Rim Kim ),서규범 ( Kyu Bum Seo ),윤진호 ( Jin Ho Yoon ),박용근 ( Yong Keun Park ),남욱 ( Uk Nam ) 대한스포츠의학회 2009 대한스포츠의학회지 Vol.27 No.1
To evaluate the clinical and radiological results of acromioclavicular dislocation and distal clavicular fracture after a Wolter plate fixation. Surgical reduction and fixation using Wolter plate was done in 18 patients with acromioclavicular dislocation and the distal clavicular fracture from February 2004 to February 2007. Clinical results of all patients were assessed using UCLA score. Radiologic outcomes were evaluated by measuring the coracoclavicular distance between the normal and injured side, vertical displacement of clavicle and bony union of distal clavicle. The mean duration of follow up was 17.7 (12-39) months. Postoperative radiographs showed that vertical displacement of the clavicle was restored in all cases. The mean UCLA score at the final follow up was 31.7 (30-35) and a good bony union was obtained in all cases with distal clavicle fracture. Complications such as reduction loss after plate removal, osteolysis and the skin necrosis around the long hook were seen. We believe Wolter plate is useful for treating patients with acromioclavicular dislocation and the distal clavicle fracture because it provides enough stability for active postoperative rehabilitation. However, careful operative planning and familiarity with the technique are necessary to prevent complications including reduction loss, osteolysis and skin necrosis around the long hook.
경골 골절후 발생한 족부 변형들의 분석 및 치료 결과에 대한 분석
김정렬,김영신,신성진,김상림,서규범,Kim, Jung-Ryul,Kim, Young-Sin,Shin, Sung-Jin,Kim, Sang-Rim,Seo, Kyu-Bum 대한족부족관절학회 2009 대한족부족관절학회지 Vol.13 No.2
Purpose: We wanted to evaluate the relating factors for deformities of the foot after tibial fracture and the outcome of respective surgical treatment. Materials and Methods: We studied thirty-two patients (thirty-five feet) who had foot deformities after tibia fracture. The age, gender, shape, location, concurrent soft tissue injury and operative treatment of tibial fracture were analysed and outcome of the surgical treatment was investigated. Results: Deformities of the foot mostly occurred in open fractures of Gustilo type 3 or closed fracture with severe soft tissue injury. Variable surgical treatments such as simple release, lengthening, Z-plasty and osteotomy were performed. The AOFAS ankle-hind foot scale was improved from average of 37.3 points preoperatively to an average of 77.2 points at the last follow up. The Maryland foot score was from 42.9 to 90.2 and AOFAS Lesser Toe Metatarso-phalangeal interphalangeal scale was from 42.9 to 90.5. Radiological correction was also improved from 21.9 degrees to 7.9 degrees (Meary angle), from 112.2 to 138.5 (Hibb's angle) and from 33.8 to 25.9 (Calcaneal pitch). Conclusion: We proposed that great care should be taken of treatment for the tibial fracture and early detection and proper management of the foot deformities are crucial.
김상림,남광우,최성욱,방형식,서규범,Kim, Sang Rim,Nam, Kwang Woo,Choi, Sung Wook,Bang, Hyeong Sik,Seo, Kyu Bum The Korean Society for Microsurgery 2012 Archives of reconstructive microsurgery Vol.21 No.2
Intramuscular schwannomma is unusual and rare cases were reported in the literature in the gluteus maximus muscle. We present a case of an intramuscular schwannoma arising from the gluteus maximus muscle in a sixty-five-year-old woman. An oval in shape and well encapsulated tumor was found embedded with the gluteus maximus muscle, and then the lesion was excised surgically. Two years following excision of the lesion, the patient remained asymptomatic, with no evidence of local recurrence.
만성 신부전 환자에서의 동시에 발생한 양측성 자발성 대퇴사두근 인대의 파열
최성욱 ( Sung Wook Choi ),김상림 ( Sang Rim Kim ),남광우 ( Kwang Woo Nam ),서규범 ( Kyu Bum Seo ),신성진 ( Sung Jin Shin ),서준영 ( Jun Young Seo ),김경민 ( Gyeong Min Kim ),방형식 ( Hyeong Sik Bang ) 대한스포츠의학회 2010 대한스포츠의학회지 Vol.28 No.2
Spontaneous bilateral rupture of the quadriceps tendons without a significant history of trauma is an uncommon disease. It is generally associated with mechanical factors and coexisting systemic and local factors are taken into consideration in the pathogenesis of these ruptures. In patients with some chronic systemic diseases, simultaneous rupture can occur spontaneously or with minor trauma. We present a case of patient with chronic renal failure on hemodialysis for the past 9 years, who sustained this injury, and subsequently had surgical repair of both tendons. We performed a preoperative magnetic resonance imaging to confirm the diagnosis, then we repaired the ruptured quadriceps tendons and performing MRI postoperatively 1 yr later. He regained his normal knee joint functions 1 yr after the operation.
자동차 정비공에서 발생한 수부 소지구 부위의 외상후 동정맥혈관종
남광우(Kwang Woo Nam),강상민(Sang Min Kang),신성진(Sung Jin Shin),서규범(Kyu Bum Seo) 대한정형외과학회 2013 대한정형외과학회지 Vol.48 No.2
동정맥혈관종은 주로 사지와 두피에서 발생하며, 여성과 아이들에게서 흔하게 보고되고 있다. 그러나 외상후 동정맥혈관종에 대한 보고는 매우 드물며, 신경학적 증상이 동반된 수부 소지구 부위에 발생한 외상후 동정맥혈관종에 대해서는 보고된 바가 없다. 이에 저자들은 반복적인 외상후 수부 소지구 부위에서 동정맥혈관종이 발생한 52세 남자 환자에서 수술적 제거술을 시행하고 좋은 결과를 얻었기에 문헌고찰과 함께 보고하고자 한다. Arteriovenous hemangiomas are found mainly in the limbs and scalp, and are common in women and children. However, there have been very limited reports concerning posttraumatic arteriovenous hemangioma, and none was reported in the medical literature regarding posttraumatic arteriovenous hemangioma of hypothenar eminence causing neurologic symptoms. We report a case of arteriovenous hemangioma of hypothenar eminence after recurrent trauma that was successfully treated by an excision of the mass and vein graft.
한 분절 요추부 퇴행성 질환에 대한 TFC 단독 사용의 임상적 유용성
송경진(Kyung-Jin Song),임영진(Young-Jin Lim),최병완(Byung-Wan Choi),서규범(Kyu-Bum Seo) 대한정형외과학회 2008 대한정형외과학회지 Vol.43 No.2
목적: 퇴행성 요추부 질환에서 threaded titanium fusion cage (TFC)와 자가 장골을 이용한 한 분절 후방 추체간 유합술의 방사선학적 평가와 임상적 결과를 분석해 TFC의 유용성을 확인해 보고자 하였다. 대상 및 방법: TFC 만을 이용해 한 분절 후방 추체간 유합술을 시행 후 최소 3년 이상 추시 가능한 환자 37명을 대상으로 하였다. 임상적 결과의 평가는 요통, 하지 방사통, 일상생활에서 활동의 제한 여부 및 통증으로 인한 약의 복용 여부를 문진하여 Ragab 등의 평가 기준을 이용하여 평가하였다. 방사선 소견으로 요추 전만도, 분절간 전만도, 추간판 높이, 골유합율을 평가하였다. 결과: 추간판의 평균 높이는 술 전 6.18±2.54 ㎜, 술 후 11.71±1.60 ㎜, 최종 추시 9.94±1.94 ㎜로 술 전에 비해 최종 추시시 증가를 보이고 있었다. 요추부 평균 전만도는 술 전 에 27.46±11.47°, 최종 추시시 31.41±8.89°, 분절간 평균 전만도는 술 전에 11.51±9.35°, 최종 추시시 10.86±7.49°로 유의한 변화는 보이지 않았다. 임상적 결과는 89.2%에서 양호 이상의 결과를 얻었으며 73.0%에서 골유합 소견을 보였다. 결론: 한 분절 요추부 퇴행성 질환에서 TFC를 사용한 유합술은 추간판 높이와 요추부 전만각 유지 및 만족할 만한 임상적 결과를 얻을 수 있는 효과적인 수술방법으로 생각된다. Purpose: To evaluate the clinical and radiologic efficacy of posterior lumbar interbody fusion (PLIF) using a threaded fusion cage (TFC) alone with autogenous iliac corticocancellous bone graft for single-level degenerative lumbar spinal disorders. Materials and Methods: Thirty-eight consecutive patients receiving PLIF with TFC alone were evaluated with at least three years of follow-up. Clinical outcome and satisfaction were assessed using Ragab's measurements. Radiological outcomes were analyzed in terms of lumbar lordosis, segmental lordosis, disc height, and fusion rates. Results: Disc height was 6.18±2.54 ㎜, 11.71±1.60 ㎜ and 9.94±1.94 ㎜ on average for preoperative, postoperative, and final follow-up, respectively. Lumbar lordosis was 27.46±11.47°, 31.41±8.89° on average for preoperative and at final follow-up, respectively. Segmental lordosis was 11.51±9.35° preoperatively, and 10.86±7.49° at final follow-up. Satisfactory clinical outcome were obtained in 89.2% of patients with successful bone fusion in 73.0% of patients. Conclusion: Stand alone TFC is an effective treatment modality in maintenance of disc height and lumbar lordosis, with satisfactory long term clinical outcomes in the treatment of single-level degenerative lumbar spinal disorders.