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고덕환,김형준,오성학,김병준,김성재 대한정형외과학회 2018 Clinics in Orthopedic Surgery Vol.10 No.4
Background: We conducted this study to determine the optimal length of patellar and tibial bone blocks for the modified transtibial (TT) technique in anterior cruciate ligament (ACL) reconstruction using the bone-patellar tendon-bone (BPTB) graft. Methods: The current single-center, retrospective study was conducted in a total of 64 patients with an ACL tear who underwent surgery at our medical institution between March 2015 and February 2016. After harvesting the BPTB graft, we measured its length and that of the patellar tendon, patellar bone block, and tibial bone block using the arthroscopic ruler and double-checked measurements using a length gauge. Outcome measures included the length of tibial and femoral tunnels, inter-tunnel distance, length of the BPTB graft, patellar tendon, patellar bone block, and tibial bone block and graft-tunnel length mismatch. The total length of tunnels was defined as the sum of the length of the tibial tunnel, inter-tunnel distance and length of the femoral tunnel. Furthermore, the optimal length of the bone block was calculated as (the total length of tunnels – the length of the patellar tendon) / 2. We analyzed correlations of outcome measures with the height and body mass index of the patients. Results: There were 44 males (68.7%) and 20 females (31.3%) with a mean age of 31.8 years (range, 17 to 65 years). ACL reconstruction was performed on the left knee in 34 patients (53%) and on the right knee in 30 patients (47%). The optimal length of bone block was 21.7 mm (range, 19.5 to 23.5 mm). When the length of femoral tunnel was assumed as 25 mm and 30 mm, the optimal length of bone block was calculated as 19.6 mm (range, 17 to 21.5 mm) and 22.1 mm (range, 19.5 to 24 mm), respectively. On linear regression analysis, patients’ height had a significant correlation with the length of tibial tunnel (p = 0.003), inter-tunnel distance (p = 0.014), and length of patellar tendon (p < 0.001). Conclusions: Our results indicate that it would be mandatory to determine the optimal length of tibial tunnel in the modified TT technique for ACL reconstruction using the BPTB graft. Further large-scale, multi-center studies are warranted to establish our results.
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VIII 인자에대한 항체를 가진 혈우병 환자에서발생한 상완골 과상 골절- 1예 보고 -
고덕환,김동헌,김규현,임신우 대한골절학회 2002 대한골절학회지 Vol.15 No.1
VIII 인자에대한 항체를 가진 혈우병 환자에서 발생한 골절은 매우 드믈며 이 경우 항혈우병 보충 치료와 그 수술적 치료에 큰 어려움이 따른다. 저자들은 VIII 인자에대한 항체를 가진 혈우병 환자에서요골 신경 마비를 동반한 상완골 과상 골절 1례를 수술적으로 치료하였으며 이를 문헌 고찰과 함께보고하고자 한다. 색인 단어 : 혈우병, VIII 인자에대한 항체, 상완골 과상 골절대한골절학회지 제15권, 제1호,2 0 0 2 년 1월The Journal of the Korean Society of Fractures
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대퇴골 전자간 골절을 동반한 고령의 환자에서 시행한 슬관절 전치환술
고덕환,김동헌,김규현,신주용,양준호 건국대학교 의과학연구소 2001 건국의과학학술지 Vol.11 No.-
Purpose: To analyze the clinical results of total knee arthroplasty In elderly patients who had arthritic knees and intertrochanteric fractures. Materials and Methods: From fan 1992 to March 1999, 27 cases of the patients with arthritic knees and associated intertrochanteric fractures were treated by total knee arthroplasties and we evaluated the patients by Knee Score of American Knee Society. Results: Flexion contracture was improved from 10.3 degree to 5.2 degree, KSS score was improved from 57.4 points to 78.6 points, authors' evaluation system score was improved from 50.3 points to 73.2 points. Conclusion: In elderly patients with arthritic knees and associated intertrochanteric fractures, total knee arthroplasty seemed to decrease the rehabilitation time and allow earl weight bearing, so provide an improvement in quality of life.
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오정환,고덕환 건국대학교 의과학연구소 1994 건국의과학학술지 Vol.4 No.-
Carpal tunnel syndrome is ascribed to a delayed median nerve compression within the carpal tunnel, characterized by tingling sensation or numbness anlong the median nerve distributed area below the wrist. it can be caused by various factors which make the carpal tunnel narrow. Surgical release of the carpal ligament is required if the symptoms persist or becoming severe in spite of the conservative treatment and simple resection of the carpal ligament without internal neurolysis is reported to be sufficient with good clinical results. We used a new technique of the carpal tunnel release with an arthroscope for the carpal tunnel syndrome and had a satisfactory clinical results with a minimal skin incision, early exercises without immobilization and short hospitalization with low cost and time-saving at the base of day surgery. So we are reporting this new, simple and advantageous technique with a review of the literatures.
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고령의 불안정성 대퇴 전자간 골절시 대퇴거 대치형 주대를 이용한 양극성 고관절 반치환술
고덕환,김규현,신주용,임신우,김동현 대한골절학회 2003 대한골절학회지 Vol.16 No.1
목 적 : 고령의 대퇴골 전자간 불안정성 분쇄골절시 대퇴거 대치형 주대를 사용하여 인공관절 치환술을 시행한 후 수술 시간, 보행 시기, 및 그 기능적 결과와 합병증을 분석하고자 하였다. 대상 및 방법 : 1991년 8월부터 2001년 1월까지 본원에서 대퇴 전자간 불안정성 분쇄골절로 수술받은 75세 이상 환자중 대퇴거 대치형 주대를 이용한 양극성 고관절 반치환술을 시행받은 후 2년 이상 추시가 가능하였던 환자 20례를 대상으로 하였다. 결 과 : 수술 시간은 평균 45분이었고, 임상적 결과 분석에서 Harris Hip Score는 평균 84.7점이었다. 사각보행의 시기는 평균 8일이었으며, 전체중 부하는 평균 6.9주였다. 합병증으로 수술부위 감염 2례, 고도의 대퇴부 동통 1례 및 탈구 1례가 발생하였다. 결 론 : 고령의 환자에서 발생한 대퇴 전자간 불안정성 분쇄 골절의 치료에 있어서 대퇴거 대치형 주대를 이용한 양극성 고관절 반치환술은 비교적 조기 체중부하와 기능적 회복이 가능하고 낮은 합병증으로 좋은 치료법의 하나로 사료된다. Purpose : The purpose of this paper is to analyze the operating time, timing of ambulation, functional results and complications using the calcar replacement stem for the severely comminuted unstable intertrochanteric fractures in the eldertly patients. Materials and Methods : From August 1991 through January 2001, 20 elderly patients over the 75 year old patients had undergone bipolar hemiarthroplasty with calcar replacement stem for the treatment of unstable intertrichanteric fractures. Results : The mean operating time was 45 minutes and mean Harris Hip Score was 84.7. Ambulation with walker was started at post-operative 8 days and full weight bearing was 6.9 weeks, each. Complications were 2 cases of wound infection, 1 case of severe thigh pain and 1 case of dislocation. Conclusion : Early ambulation, functional restoration and decrease of the complications with bipolar hemiarthroplasty using calcar replacement stem for severely comminuted unstable intertrochanteric fractures in elderly patients, therefore this methods seems to be one of the effective treatments.
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