소아의 급성 혈행성 골수염에 대한 임상적 고찰

고한석(Han Suk Go),안종국(Jong Gook Ahn),김병직(Byung Jik Kim),서광윤(Kwang Yoon Seo) 대한정형외과학회 1983 대한정형외과학회지 Vol.18 No.5

슬개골 골절의 임상적 고찰

김병직(Byung Jik Kim),고한석(Han Suk Go),임영(Young Lim),김환수(Hwan Soo Kim) 대한정형외과학회 1990 대한정형외과학회지 Vol.25 No.1

제 12 차 대한골절학회 학술대회 (주연제) : 10. 관절내 골절을 동반한 주관절 탈구 3례 보고

김병직(Byung Jik Kim),고한석(Han Suk Go),임영(Young Lim),주석규(Suk Kyu Choo) 대한골절학회 1990 대한골절학회 학술대회 및 초록집 Vol.- No.-

대퇴골 전자간 골절에서의 감마 금속정 사용에 관하여

권칠수 ( Chil Soo Kwon ),김병직 ( Byung Jik Kim ),고한석 ( Han Suk Go ),김용욱 ( Young Uck Kim ),김응선 ( Eung Sun Kim ) 대한고관절학회 1991 Hip and Pelvis Vol.3 No.2

Through operative treatment by internal fixation, the mortality and complication in pertrochanteric fracture decreased markedly. After introduction of compression hip screw, it is accepted as a standard method in pertrochanteric fracture and contributed to decreaseing the mortality and complication. But it is pointed out that the compression hip screws have prolblems such as difficulty in reduction, cutting out and jamming. Also operation risk is very high in partient with poor general condition and old age. Gamma nail, a kind of interlocking nail was recently introduced. Since it is a closed intramedul- lary nail, it has an advantage such as low intraoperative blood loss, and less soft tissue injury. Also it has an advantage of a comprssion screw and biomechanical advantage such as short lever arm, low vertical force component and low axial torque component. In this paper, authors are reporting 8 cases of pertrochanteic fractures of femur treated by Gamma nailing from September, 1990 to June, 1991.

골수강내 교합정을 이용한 장관골 지연 및 불유합의 치료

고한석,안응선,윤윤성 대한골절학회 1994 대한골절학회지 Vol.7 No.1

Delayed & non-union are common complications of the fracture of long bones. Many kinds of treatment modalities for delayed & non-union have been reported, but rigid fixation and bone graft have been the most common accepted method. The interlocking intramedullary nailing technique has advantages which the rigid internal fixation and bone grafting effect of reaming debris. We treated nine cases of delayed k. non-union of femur and tibia at the Department of Orthopedic Surgery, Seoul Paik Hospital from Jan. 1990 to Octo. 1992 and results were as follows. 1. Nine cases of the delayed & non-union were consisted by 7 cases of femur and 2 cases of tibia. 2. Causes of delayed k non-union were failure of implants in 4 cases, inadequate and inappropriate immobilization in 3 cases, and persistent gap in 2 cases. 3. Union was achieved in 7 cases and union rate is 77.8%

소아 상완골 외과 골절의 수술적 치료에 대한 임상적 고찰

김병직,고한석,장구락 인제대학교 1990 仁濟醫學 Vol.11 No.2

소아 주관절 골절 중 비교적 드문 손상인 상완골 외과 골절의 수술적 치료 후 6개월 이상 추시한 26례를 분석, 문헌 고찰과 함께 보고하는 바이다. Lateral condyle fractures of the humerus is common in children, and it may be one of the most difficult fracture to treat, and has many controversy in treatment method. To obtain good result, anatomical reduction and firm fixation is obligatory. We analysed the 26 cases of lateral condyle fractures of the humerus in children that could be followed up at Paik hospital, Inje University, Seoul from March 1983 to March 1988. 1.Male predominate in a ratio of above 5 : 1. 2.The age ranged from 2 to 12 years, and its mean was 6.3 years. 3.The causes of the injury were falling down in 14 cases, slipping down in 11 cases, and traffic accident in only one case. 4.16 cases (61.5%) were Milch type 1 and 10 cases (38.5%) were Milch type 2. 5.We could not find the change of carrying angle during the follow up period in all cases. 6.The range of motion were nearly full in all cases. 7.There were 2 cases of the superficial infection in the K- wire inserted site. 8.We thought that early anatomical reduction and internal fixation with K- wire will promise good functional results.

장관골의 지연유합 및 불유합의 치료에서 교합성 골수강내 금속정의 이용

김진구,김병직,주석규,고한석,장준우,서정국 대한골절학회 1998 대한골절학회지 Vol.11 No.4

Of the several nonoperative and operative options described for the treatment of delayed union and nonunion of the long bone, interlocking nailing with reaming offers the effect of internal splint, autogenous bone graft and early return to a normal way of life. The purpose of this study is to evaluate the usefulness and complication of intramedullary(IM) naling with reaming by retrospective method. We treated 34 patients with delayed union or nonunion of the tibia, femur, and humerus by interlocking nailing with reaming between January 1992 and December 1996. The results were as follows; l. Of the 34 cases, there were 13 tibia fracture, 17 femur fracture, 4 humerus fracture. Half of them were ununited and another half were delayed in fracture healing. 2. Previous methods of treatment were conservative treatment in 2 cases, external fixator in 2, plate & screws fixation in 8, Ender nail in 2, Kuntscher nail in 2 and interlocking nail in 7 among 24 cases of closed fracture and external fixator in 8 and interlocking nail in 2 among 10 cases of open fracture. 3. Twenty-five patients were treated with closed nailing and 9 were treated with open nailing. Iliac bone graft was performed at 3 cases and fibulotomy was performed at I case. 4. Union was obtained in 33 cases and 1 case needed additional bone grafting to achieve union. 5. Postoperative complications were one nonunion, two entry site pain, one screw breakage, one heterotopic ossification, and one postoperative infection. Interlocking nailing with reaming was associated with a high union rate(97%) in our series. The authors believe that IM nailing with reaming is a useful option for treatment of delayed or nonunion of the long bone fracture.

Internal bone Transport 를 이용한 장관골의 감염성 불유합의 치료

이동훈,김진구,김병직,임영,고한석,서정국 대한골절학회 1998 대한골절학회지 Vol.11 No.3

Infected nonunion of long bone frequently accompanies with bone loss, because of the outcome of initial trauma or iatrogenic result from sequestra resection. In this study, infected and ununited long bone fracture was treated with internal bone transport technique which was first discribed by G.A. Ilizarov. There were eleven tibial and two femural nonunion. The mean number of admission was 2.8 times; mean number of operation was 8 times; mean duration of treatment was 16.5 Mo; 8.5cm of mean defect was lengthened during the mean of 136 days, and average healing index was 1.95 month/cm. All infections were cured and all nonunions were united. Functional result was excellent in 5 cases (of 13 cases), good in 5, fair in 2, and 1 had poor result. Many complication had been observed. All had infection of pin site and pain at least one time, 5 had stiff knee, 9 had stiff ankle, early consolidation(1), delay consolidation(3), tibiofivular synostosis(5), nerve injury(1), refracture after union(l), angular deformity over 5 degree(7), rotational deformity over 10 degree(2).

원위요골 분쇄골절의 외고정기구를 이용한 수술적 치료

김병직,임영,주석규,신재기,고한석,서정국 대한골절학회 1996 대한골절학회지 Vol.9 No.2

Comminuted fractures of distal radius are usually unstable and complex injuries, which require prolonged treatment and often result. in some degree of permanent disability. Previous treatment was mainly closed reuction and cast immoibilization, and operative treatment of accurate open reduction, internal fixation and bone graft when needed. Bui recently ligamentotaxis of the fracture using external fixation device has been widely employed. Which could be followed up for 12 cases of comminuted fractured of distal radious operated with external fixation, more than 1 year, during the period of September 1090 to September 1994 at Seoul Paik Hospital was reviewed. According to Frykman's classification, the most common type was type 7B(7 cases, 58.3%). There was l open fracture, and 7 combined injuries of ipsilateral upper extremity. According to AO classification, 9 cases(75%) were type C2 and C3. The most common cause was falling down from a height(6 cases). Additional limited internal fixation was done in 5 cases, all 12 cases were treated external 1'ixalors. Results. were defined with modified Gartland K Werley's demerit pointing system, excllent was 6 cases(50% ), good was 4 cases(33.3/n), poor was 2 cases. Surgical treatment using external fixators and/or limited open reduction was good method for comminuted distal radius.

대퇴골 전자하부 골절에 이용한 금속판 및 골수강내 금속정 고정술의 비교

최재성,김병직,주석규,고한석 대한골절학회 1994 대한골절학회지 Vol.7 No.2

Management of subtrochanteric fractures of the femur is difficult because it occurs in bone that is predominantly cortical and high stress concentrates in this region. The subtrochanteric fracture is difficult for the accurate reduction and maintenance because many of these fractures are cmminuted from high velocity trauma and its proximal fragment is severely displaced by adjacent strong muscles pooling. Therefore, as a rule we prefer to treat subtrochanteric fractures by operative means if possible. Many intemal fixation devices have been recomended for use in subtrochanteric fractures and their selection should be based on the individual fracture anatomy. In recent years, generally accepted two methods are intramedullary nailing and plate fixation. We have reviewed our experience using the intramedullary fixatian on 14 cases of subtrochanteric femur fracture and compared the result with those of 14 cases of plate fixation. All the 28 cases were treated at the Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University in the period from March 1988 to March 1993. Intramedullary fixation were implanted with shorter operating time, smaller incisions, and less intraoperative bleeding. The intramedullary fixation group had a shorter covalescence and earlier full weight-bearing but no significant difference in fracture union rate with plate fixation group. We conclude that with careful surgical technique, the intramedullary fixation was a more suit- able method for the treatment of the suhtrochanteric femoral fractures.