요골 두 아탈구와 동반된 상완골 내 상과 골절 : 1예 보고 A Case Report

이한용,유기원,정진영,송주현,고해석,강용구,손문익 대한골절학회 2003 대한골절학회지 Vol.16 No.2

주관절 손산 중 상완골 내 상과 골절은 단독으로 혹은 주관절 탈구와 동반되어 발생하는 것이 일반적이다. 저자들은 15세 남자 환자의 좌측 요골 두 아탈구가 동반된 상완골 내 상과 골절을 경험하였다. 도수 정복을 시도하였으나 요골 두 아탈구의 정복을 얻을 수 없어 관혈적 정복술로 치료하엿다. 6개월추시 결과 후휴증이 없는 정상적인 관절 상태를 확인할 수 있었다. 연령, 원인 , 손상 기전으로 분석해 보면 이 동반 손상은 발생하기 매우 어렵고, 문헌 탐색 결과 현재까지 동일한 증례를 찾아볼 수 없었으므로 보고하는 바이다. It has been known that fracture of medial epicondylar apophysis of distal humerus may be isolated of associated with elbow deslocations. We have experienced a case which medial epicondylar fracture of the distal humerus was associated with subluxation of the radial head. Initially, we had tried reduction of subluxated radial head by closed method, but failed. Finally open reduction gad been performed. At 6 month after open reduction, clinical and radiological result were excellent. As it is difficult for those associated injuries to occur simultaneously and the similar cases never have been reported yet, we would like to present this case with a review of the literature.

Management of Blood Loss in Hip Arthroplasty: Korean Hip Society Current Consensus

( Joo-hyoun Song ),( Jang Won Park ),( Young-kyun Lee ),( In-sung Kim ),( Jae-hwi Nho ),( Kyung-jae Lee ),( Kwan Kyu Park ),( Yeesuk Kim ),( Jai Hyung Park ),( Seung Beom Han ) 대한고관절학회 2017 Hip and Pelvis Vol.29 No.2

The volume of hip arthroplasty is stiffly increasing because of excellent clinical outcomes, however it has not been shown to decrease the incidence of transfusions due to bleeding related to this surgery. This is an important consideration since there are concerns about the side effects and social costs of transfusions. First, anemia should be assessed at least 30 days before elective hip arthroplasty, and if the subject is diagnosed as having anemia, an additional examination of the cause of the anemia should be carried and steps taken to address the anemia. Available iron treatments for anemia take 7 to 10 days to facilitate erythropoiesis, and preoperative iron supplementation, either oral or intravenous, is recommended. When using oral supplements for iron storage, administer elemental iron 100 mg daily for 2 to 6 weeks before surgery, and calculate the dose using intravenous supplement. Tranexamic acid (TXA) is a synthetic derivative of the lysine component, which reduces blood loss by inhibiting fibrinolysis and clot degradation. TXA is known to be an effective agent for reducing postoperative bleeding and reducing the need for transfusions in primary and revision total hip arthroplasties. Patient blood management has improved the clinical outcome after hip arthroplasty through the introduction and research of various agents, thereby reducing the need for allogeneic blood transfusions and reducing the risk of transfusion-related infections and the duration of hospitalizations.

Internal Fixation of Pauwels Type-3 Undisplacedincomplete Insufficiency Femoral Neck Fractures with Cephalomedullary Nails

Joo-Hyoun Song,Jongmin Kim,Seungbae Oh 대한고관절학회 2020 Hip and Pelvis Vol.32 No.2

Femoral neck stress fractures are rare and when treating are difficult to achieve favorable outcomes. This study characterizes outcomes associated with the use of cephalomedullary nails for fixation of Pauwels type-3 vertical femoral neck undisplaced-incomplete insufficiency fractures. Four consecutive patients with a Pauwels type-3 vertical femoral neck tensile insufficiency fracture from 2016 to 2018 were reviewed. Magnetic resonance imaging data revealed tensile visible fracture lines and hip-joint effusions with a high shear angle. For all patients, bone mineral density and vitamin D levels were low; vitamin D therapy was initiated immediately. Surgical procedures were conducted with cephalomedullary nails (Gamma 3 locking nail system; Stryker) under general anesthesia. A cephalomedullary nail appears to be a safe and effective alternative to the use of multiple parallel screws or a sliding hip screw for fixation of vertical femoral neck stress fractures (level of evidence: Level V).

Comparison of Perioperative Blood Loss in Primary Non-cemented Total Hip Arthroplasty for Rapidly Destructive Coxarthrosis and Osteonecrosis of the Femoral Head

( Joo Hyoun Song ),( Suk Ku Han ),( Kyung Hoon Lee ),( Jae Min Lee ),( Kee Haeng Lee ) 대한고관절학회 2015 Hip and Pelvis Vol.27 No.3

Purpose: The purpose of this study is to compare the perioperative blood loss in primary non-cemented total hip arthroplasty (THA) performed for rapidly destructive coxarthrosis (RDC) with the perioperative blood loss in primary non-cemented THA for typical osteonecrosis of the femoral head (ONFH). Materials and Methods: From January 2000 to December 2013, 19 patients were diagnosed with RDC (group 1) and 40 patients were diagnosed typical Ficat stage IV ONFH (group 2), comparison of perioperative blood loss between group 1 and group 2 in primary noncemented THA was done. Patients with preoperative usage of steroid or anticoagulants medication and with hemodynamic abnormal blood test results were excluded. The blood loss was measured up to the fifth post operation day and calculated with formula proposed by Mercuriali, Inghilleri and Nadler. Results: Non-compensated blood loss calculated in milliliters of red blood cells was 362 mL (standard deviation [SD], 187; range, 77-675) in group 1 and 180 mL (SD, 145; range, 53-519) in group 2. Compensated blood loss was 630 mL (SD, 180; range, 380-760) in group 1 and 503 mL (SD, 260; range, 190-1, 505) in group 2. The total blood loss after primary non-cemented THA is greater when surgery is performed for RDC than for ONFH, with the volume of 992 mL (SD, 300; range, 457-1, 434) in group 1 and 683 mL (SD, 360; range, 226-1, 975) in group 2 respectively. Conclusion: Total perioperative blood loss was significantly greater in RDC than in ONFH in primary noncemented THA.

고관절부 골절의 수술적 치료 : 대퇴골 전자간부 골절의 수술적 치료

송주현 ( Joo Hyoun Song ) 대한고관절학회 2006 Hip and Pelvis Vol.18 No.4

Henoch-Schönlein 자반증에서의 관절증상

송주현(Joo-Hyoun Song),강용구(Yong-Koo Kang),이한용(Han-Yong Lee),고해석(Hae-Seok Koh),유기원(Kee-Won Rhyu),신상영(Sang-Young Shin) 대한정형외과학회 1998 대한정형외과학회지 Vol.33 No.5

최소 침습 도달법을 이용한 인공고관절 전치환술

송주현 ( Joo Hyoun Song ),이은봉 ( Eun Bong Lee ) 대한고관절학회 2009 Hip and Pelvis Vol.21 No.3

최근에 복강경, 내시경 그리고 관절경 수술과 같이 최소 침습법을 이용한 시술이 보편화되었으며, 40년 이상의 경험이 쌓인 인공 고관절 치환술에서도 이와 같은 맥락에서 절개부위를 최소화하는, 소위 최소 침습법에 의한 인공 고관절 치환술이 시도되고 있다. 최소 침습법에 의한 인공고관절 치환술은 절개 부위와 연부 조직 손상이 적어 수술 후 통증 감소와 빠른 회복을 얻을 수 있다는 장점을 내세우고 있으나, 이 술식의 장단점과 주의 사항을 면밀히 검토하여 환자 치료에 있어 부정적인 결과가 초래되는 것을 막아야한다. Minimally invasive surgeries, such as laparoscopic, endoscopic and,arthroscopic surgery are currently being used throughout the world. The field of total hip arthroplasty has over 40 years of experience, and minimally invasive total hip arthtoplasty was introduced to reduce the perioperative morbidities. The advocates for minimally invasive total hip arthroplasty will point out the advantages of reduced pain and early ambulation after the operation because of the minimal soft tissue injury. However, we have to review the advantages and disadvantages of minimally invasive total hip arthroplasty to prevent anyharmful effects of this procedure for the patients who under go it.

Mallory-Head System을 이용한 인공 고관절 전치환술 -최소 8년 추시 결과-

송주현 ( Joo Hyoun Song ),이주엽 ( Ju Yup Lee ),정인호 ( In Ho Jung ),유현호 ( Hyun Ho Yoo ) 대한고관절학회 2009 Hip and Pelvis Vol.21 No.1

목적: 이중 tapered 된 Mallory-Head 인공 대퇴 삽입물을 이용한 고관절 전치환술의 임상적, 방사선적 추시 결과를 확인하고자 하였다. 대상 및 방법: 인공 고관절 전 치환술을 받은 81예(75명)의 환자에 대한 평균 9.8년(8~12년)까지의 수술 후 추시 결과를 분석하였다. 수술 전 진단은 46예(57%)가 대퇴 골두 무혈성 괴사, 12예(15%)에서 골관절염, 9예(11%)에서 류마티스 관절염 등이었다. 임상적 결과는 modified Harris 점수와 modified Merle d`Aubigne-Postel 점수로 평가하였고, 방사선학적 결과를 분석하였다. 결과: 평균 modified Harris hip score는 술 전 56점에서 술 후 92점으로 향상되었다. Modified Merle d`Aubigne-Postel score는 최종 추시에서 평균 15점으로 55예(68%)가 good 또는 excellent의 임상적 등급으로 분류되었다. 1예에서 비구컵의 해리로 인한 재치환술을 요하였으며, 1예는 반복적 탈구로 인한 재치환술을 시행하였다. 결론: Mallory-Head 인공 대퇴 시스템을 이용한 전 치환술의 중장기 임상적 및 방사선적 결과는 우수한 것으로 판단된다. Purpose: The purpose of this study was to assess the clinical and radiographic results of total hip arthroplasty with using the double tapered Mallory-Head system. Materials and Methods: The clinical and radiographic results of a consecutive series of 81 total hip replacements in 75 patients were reviewed at eight to twelve years (average: 9.8 years) postoperatively. The underlying diseases were avascular necrosis in 46 hips (57%), osteoarthritis in 12 hips (15%), RA in 9 hips (11%) and others. The clinical result was evaluated on the basis of the modified Harris hip score and the modified Merle d`Aubigne-Postel score. A radiographic analysis was also performed. Results: The average modified Harris hip score was improved from preoperative 56 points to postoperative 92 points. The average modified Merle d`Aubigne-Postel score was 15 points at the latest follow up, and 55 hips (68%) were classified as having clinical grades of excellent or good results. One acetabular component was revised because of loosening, and one was revised because of recurrent dislocation. Conclusion: The clinical and radiological evaluations of the total hip replacements using the Mallory-Head system showed good results.

인공 고관절 주위 골절

송주현 ( Joo Hyoun Song ) 대한고관절학회 2007 Hip and Pelvis Vol.19 No.3

양극성 고관절 반치환술 후 탈구

송주현(Joo-Hyoun Song),강용구(Yong-Koo Kang),이한용(Han-Yong Lee),고해석(Hae-Seok Koh),유기원(Kee-Won Rhyu),김정호(Jeong-Ho Kim) 대한정형외과학회 1999 대한정형외과학회지 Vol.34 No.3