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- 저자 : 김강해(Kim Kang Hae) (검색결과 4 건)
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송해룡,김강일,조세현,구경회,박형빈,정순택,황선철,강번중 대한골절학회 2001 대한골절학회지 Vol.14 No.4
Purpose: To determine the advantages of triradiate approach in complex acetabular fractures, the results were reviewed for 24 patients who had open reduction and internal fixation of complex acetabular fractures with a triradiate approach. Materials and Methods: Twenty-four patients were followed for a mean of 3 years after the operation. All patients with complex fractures of the acetabulum were treated with open reduction and internal fixation using Y-shaped triradiate incision, osteotomy of the greater trochanter, and arthrotomy of the hip joint. In 13 patients the fracture was fixed with reconstruction plates and in 11 patients the fracture was fixed with the plates and wires. Results: All fractures united and no patient required subsequent total hip replacement arthroplasty. Four patients had heterotopic ossification without serious limitation of motion of the hip and one patient had grade 4 lesion as defined by Brooker et al, which limited motion of the hip enough to impair function. Six patients showed posttraumatic arthritis at the latest radiograph. The overall clinical result was excellent for 7 hips, good for 13, and fair for 4 as defined by d`Aubigne and Postel. The radiological result was excellent for 13 hips, and good for 6 as defined by Matta. One femoral head necrosis was observed at the latest follow-up. Conclusion: A triradiate approach provides a good extra and intraarticular access to complex fracture of' the acetabulum, which facilitates an accurate reduction, rigid fixation, removal of loose osteochondral fragments and management of labral injury, without increased morbidity of the hip joint.
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인공인대와 자가 인대의 복합이식을 이용한 후방 십자 인대 재건술
송해룡,조상원,김강일,조세현,박형빈,정순택,김상림,구경희 대한슬관절학회 2001 대한슬관절학회지 Vol.13 No.2
목적 : 후방 십자 인대 재건술의 한 방법으로 Trevira^� 인공인대와 함께 골-슬개건-골 자가인대의 복합이식과 자가인대 단독이식의 결과를 비교 분석하고 수술 수기상의 문제점과 해결방법, 주의점 등을 정리함에 목적을 두었다. 대상 및 방법 : 1993년부터 1999년까지 후방 십자 인대 파열 환자 중 수술적 치료 후 2년 이상 추시했던 26례를 대상으로 단독이식군(15례)과 복합이식군(11례)간의 수술수기, KT-2000검사, International Knee Documentation Committee(IKDC)의 슬관절 기능평가, Lysholm 슬관절 평가 등으로 최종 추시 결과를 비교 분석하였다. 결과 : 최종 추시의 KT-2000 검사상 이완정도(정상측과의 차이)가 단독이식군에서 3.2mm, 복합이식군에서 1.8mm였고, IKDC 기능평가도 복합이식군이 우수하였으며, 슬관절의 운동범위와 Lysholm Knee Scoring Scale에서는 차이가 없었다. 결론 : 본 교실에서 제작한 Graft Pusher를 이용하여 killer turn을 쉽게 통과할 수 있었고, 복합 이식물을 이용하여 대퇴골의 정확한 등장점에 고정하면 조기운동이 가능하고 후방불안정의 재발을 방지할 수 있었다. 관절절개술도 관절경적 재건술과 병행할 수 있으며, 이 역시 현재까지 의미있는 술식으로 판단된다. Purpose : To evaluate the clinical efficacy and the advantages of the combined graft of Trevira^� Artificial Ligament and bone-patellar tendon-bone(BPTB) autograft for posterior cruciate ligament(PCL) reconstruction compared with the conventional single tendon graft. Materials and Methods : Twenty six cases of chronic PCL injury operated between 1993 and 1999 were divided into two groups; Group 1(15 cases) reconstructed with single tendon(11 BPTB and 4 Achilles tendon)and Group 2(11 cases) with combined graft. The average age of patients was 32(range, 19~56). Results : At the end of average follow-up of 3.5 years, there was no significant difference between the two groups in terms of range of motion and Lysholm score. KT-20000 side-to-side difference(manual maximum) was 3.2 mm and 1.8 mm respectively in Group 1 and Group 2. International Knee Documentation Committee knee score showed better result in Group 2. Conclusion : Postoperative knee stability can be better maintained in the combined graft group than in the single tendon group. Arthrotomic procedure is as effectively applied to the PCL reconstruction as arthroscopy in terms of precise location of femoral isometric point and easy passage of the killer turn by use of the special Graft Pusher designed by the authors.
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전방십자인대 스포츠손상의 관절경적 재건술 후 스포츠 활동성의 변화
조세현,박형빈,송해룡,구경회,김강일,황선철,하용찬 대한스포츠의학회 2001 대한스포츠의학회지 Vol.19 No.1
To evaluate the change in sports activity of patients who were treated with arthroscopic reconstruction of anterior cruciate ligament rupture using Bone-Patellar Tendon-Bone Autograft. We reviewed the clinical results of 74 patients, treated with arthroscopic anterior cruciate ligament reconstruction using bone-pateller tendon-bone autograft between March 1993 and March 1996. The average follow-up was 35 months. The patients who returned to the less stressful sports activity were classified as group Ⅱ. We analysed the results between group Ⅰ and group Ⅱ with IKDC (International Knee Documentation Committee) protocol and assessment of functional level. Forty-one patients(55.4%) were classified as group Ⅰ and 33 patients(44.6%) as group Ⅱ. Overall final result by IKDC protocol was normal in 17(41.5%) patients, nearly normal in 24(58.5%) patients in the group Ⅰ and nearly normal in 18(54.5%) patients, nearly normal in 18(54.5%) patients, abnormal in 15(45.5%) patients in the group Ⅱ. In the functional level, squatting was normal in all of 41(100%) patients in the group Ⅰ but normal in 10(30.3%) patients, nearly normal in 18(54.5%) patients, abnormal in 5(15.5%) patients in the group Ⅱ. Running was normal in all of 41(100%) patients in the group Ⅰ but normal in 11(33.3%) patients, nearly normal in 18(54.5%) patients, abnormal in 4(12.2%) patients in the group Ⅱ. Jumping was normal in all 41(100%) patients in the group Ⅰ and normal in 12(36.42%) patients, nearly normal in 18(54.5%) patients, abnormal in 3(9.1%) patients in the group Ⅱ. Cutting and pivoting were normal in 34(82.9%) patients, nearly normal in 7(171.%) patients, abnormal in 0(0%) patient in the group Ⅰ and normal in 0(0%) patient, nearly patients, nearly normal in 20(60.6%) patients, abnormal in 13(39.4%) patients in the group Ⅱ. In spite of stable reconstruction mechanically, only 41(55.4%) patients returned to the same stressful sports activity. The other 33(44.6%) patients returned to the less stressful sports with low IKDC results. In the functional level, cutting and pivoting activity were affected the most.
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