Treatment of Unstable Pelvic Ring Injuries

김원유 대한고관절학회 2014 Hip and Pelvis Vol.26 No.2

Pelvic fractures are classified according to the stability of the pelvic ring. Unlike stable pelvic fractures, which heal without complications, unstable fractures may lead to pelvic ring deformities, which cause severe complications. An orthopedic surgeon must determine the stability of the pelvic ring by radiography and physical examination of the patient in order to ensure early, prompt treatment. This article includes anatomy of the pelvic ring, classification of pelvic ring injuries, its treatment algorithm, and corresponding cases involving unstable pelvic ring injury.

오탁쇄골간 Wiring의 임상적 고찰

김원유 최신의학사 1992 最新醫學 Vol.35 No.8

비구골절의 분류

김원유 대한고관절학회 2004 Hip and Pelvis Vol.16 No.2

Superior Gluteal Artery Pseudoaneurysm Caused by Pelvic C-Clamp Blind Application: A Case Report

김원유,이세원,김광섭,이종윤 대한고관절학회 2017 Hip and Pelvis Vol.29 No.2

To control such a hemorrhage, a displaced pelvic ring must be rapidly reduced and stabilized with a pelvic binder, an external fixator, or a pelvic clamp. Among them, pelvic clamps can be life-saving but pin malposition may cause vascular complications. We present a case of superior gluteal artery pseudoaneurysm caused by AO pelvic C-clamp pin malposition.

Short-term Outcomes of Ceramic Coated Metal-on-Metal Large Head in Total Hip Replacement Arthroplasty

김원유,고명섭,이세원,김광섭 대한고관절학회 2018 Hip and Pelvis Vol.30 No.1

Purpose: This study characterizes the short-term outcomes of ceramic coated metal-on-metal (MoM) large head total hip arthroplasty (THA) in prospectively selected patients aged 70 to 75 years. Materials and Methods: Eighteen patients (18 hips) between the ages of 70 and 75-years old with THA using ceramic-coated MoM large heads between June 2014 and December 2014 were evaluated. We prospectively selected patients younger than 70 years for bipolar hemiarthroplasty and older than 75 years for conventional THA. There were one case of osteoarthritis, 8 cases of femur neck fracture, and 9 cases of intertrochanteric fracture. All patients underwent clinical and radiological follow-up at 6 weeks, 6 and 12 months, and every year postoperatively. The mean duration of follow-up was 24.2 months (range, 18-34 months). Results: The average Harris hip score at the final follow-up was 81.0, except one case which was ultimately converted to conventional THA due to acetabular cup loosening. Radiographically, mean acetabular cup inclination was 45.8。(range, 38-56。) and anteversion was 20.1。(range, 11-25。). The average femoral head size was 48.7 mm. All stems were neutral-positioned except 1 varus-positioned stem. There was 1 case of a soft tissue infection, 3 patients complained of persistent groin pain, and no dislocations occurred. Conclusion: Ceramic coated large MOM articulation (ACCIS) have many complications: cup loosening, groin pain, which can lead to fatal outcomes in the elderly patients. Especially in patients with communicated intertrochanter fracture (AO 31-A22, 23), careful attention should be paid to the choice of surgical option.

대퇴골 경부 골절과 동반된 Pertrochanteric fracture의 치료

김원유,한창환,최우성,지종훈,문창윤,김진영 대한골절학회 2002 대한골절학회지 Vol.15 No.3

목 적 : 대퇴골 경부 골절과 동반된 전자부 골절(pertrochanteric fracture)의 정확한 진단을 환기시키기고 이러한 경우 시행한 인공 골두 치환술의 예비적 임상결과를 보고하는데 있다. 재료 및 방법 : 대퇴 경부 골절의 동반이 의심되는 7예를 대상으로 하였으며 평균 골밀도는-4.25, Singh index는 평균 3.28이었다.모든 예에서 수술전 CT 단층 촬영술을 시행하였으며 CT소견상 대퇴골 경부 골절이 동반되었다고 판단시 양극성 인공 골두 치환술을 시행하였고 수술시 채취한 대최 골두 표본에서 골절 양상을 확인하고 사진 촬영하여 기록하였다. 수술 후 임상결과의 판정은 Postel의 임상경과 grade를 이용하여 시행하였으며 수상전의 보행상태와 비교하여 이의 회복이 가능한 시점에 주안점을 두어 조사하였다. 결 과 : 모든 예에서 수술 전 단순 방사선 및 CT 소견과 합당한 전자부 골절의 소견을 보였다. 수술 후 평균 13개월(6~19개월)에 전 례에서 양호이상의 소견을 보였으며 모든 환자에서 수상 전과 비슷한 정도로의 운동량의 회복을 보였다. 결 론 : 이러한 골절의 정확한 진단을 위하여는 골다공증이 동반된 분쇄상이 심한 대퇴부 전자부 골절에서는 CT촬영 및 정확한 판독이 필요하고 부수적으로 일단 이러한 골절이 발견 시는 조기 인공 골두치환술도 좋은 치료법이라고 생각된다. Objectives : To establish the precise diagnosis of a comminuted pertrochanteric fracture with femoral neck fracture in a senile osteoporotic patient and report of a preliminary clinical results of early bipolar hemiarthroplasty. Material & Methods : Consecutive seven cases of comminuted pertrochanteric fractures who were suspicious to have combination with femoral neck fracture were evaluated. All cases had routine radiographs and CT scans of proximal femur and performed with bipolar hemiarthroplasties. Observation of the retrieved femoral head to evaluate a fracture and recorded with photograph. Postoperative evaluation was done with Daubine & Postel clinical grading with medical recording and personal telephone. The clinical evaluation was focused on the recovery for preinjured walking distance. Results : All patients were proved to have combination with pertrochanteric fractures and femoral neck fractures. In addition, all patients were recovered to more than good in clinical grading and pre-injured walking distance. Conclusion : To make a precise diagnosis of pertrochanteric fractures with femoral neck fracture it is recommended to perform the CT scan with prompt reading of the simple radiographs in suspicious case. An early bipolar hemiarthroplasty was also recommended to treat this kind of senile difficult fracture.

전방 도달법과 수장부 T자형 금속판 고정을 통한원위 요골 골절의 치료

김원유,최우성,최동원,신윤학,김진영 대한골절학회 2003 대한골절학회지 Vol.16 No.2

대한골절과학회지 y253 Table 1.Summary of cases Preoperative Postoperative No Sex Age Fracture AO/ASIF Type of Frykmann RI (°)4 F 62 A3 2 18 1 10 8 18 10 10 0 Fair∥ FPL rupture, collapse 5 M 64 A3 2 5 22 4 5 18 14 7 0 Good 6 M 33 A3 1 16 11 10 7 23 11 10 0 Excellent 7 F 49 C1 3 15 8 -18 5 20 8 5 1 Good 8 F 65 C1 4 15 8 5 4 17 8 6 0 Excellent K-wires fixation 9 F 73 C1 3 10 5 -15 2 25 12 8 0 Excellent Ext. fixator 10 M 27 C1 3 17 12 -17 3 25 15 8 0 Excellent 11 F 76 C1 4 15 12 -10 3 20 12 10 1 Excellent Ext. fixator 12 F 60 C1 4 20 14 -6 0 10 6 5 2 Poor Scaphoid fracture 13 F 53 C2 3 10 7 -4 8 24 12 4 0 Fair Ext. fixator 14 M 53 C2 4 24 6 -34 8 22 14 8 2 Excellent 15 F 85 C2 3 20 4 -26 2 23 11 5 0 Good 16 M 50 C2 3 6 4 -12 5 14 8 10 0 Good K-wires fixation 17 M 47 C2 3 14 9 -13 5 20 14 15 0 Excellent 18 F 73 C2 6 10 5 -2 2 15 7 13 0 Good Ext. fixator 19 F 60 C3 7 12 7 -23 3 12 7 0 Good K-wires fixation 15±5.7 8.8±4.8 -11±13 4±3 20±5 11±3 7±4 0±1

원위 경골 골절의 임상양상 및 최소 침습적 금속판 고정술의 결과

김원유,지종훈,권오수,박상은,김영율,길호진,정재중,Kim, Weon-Yoo,Ji, Jong-Hun,Kwon, Oh-Soo,Park, Sang-Eun,Kim, Young-Yul,Kil, Ho-Jin,Jeong, Jae-Jung 대한족부족관절학회 2012 대한족부족관절학회지 Vol.16 No.2

Purpose: The purpose of this study is to analyze the clinical features of distal tibia fractures and to evaluate the treatment outcomes of minimally invasive plate osteosynthesis (MIPO). Materials and Methods: From January 2004 to December 2009, 84 cases of 81 patients treated with plate fixation for distal tibia fracture were enrolled in this retrospective review. We investigated age, sex, injury mechanism, fracture patterns, and complications, and the clinical features were analyzed. To evaluate the treatment outcomes of MIPO, we divided into two groups. MIPO group consisted of 55 patients were treated with MIPO technique and conventional group consisted of 18 patients were treated with open reduction and internal fixation with conventional anterolateral plating. The results were compared between two groups by assessing bony union time, operation time, amount of blood loss, range of ankle motion, clinical score by American Orthopaedic Foot and Ankle Society (AOFAS) score, and post-operative complications. Results: The mean age of 81 patients with distal tibia fracture was 54.8 years. According to AO classification, A1:2:3 were 16, 20, 16 patients, B1:2:3 were 2, 8, 7, C1:2:3 were 1, 3, 11 patients. According to injury mechanism, slip down injury was patients, traffic accident was 26, fall from height injury was 14 patients respectively. The type A fractures were lower energy trauma and more older patients. The type C fractures were higher energy trauma and younger patients. MIPO group was better than conventional group in operative time, blood loss, bony union time, and ankle joint motion. In complications, MIPO group showed no nonunion and infection, one malunion, one skin necrosis, nine skin irritations, and one screw breakage. Conventional group showed two nonunion, four infections, two skin necrosis, and one metal failure. Conclusion: Distal tibial fractures caused by low energy trauma were on the increase. Minimal invasive plate osteosynthesis was shorter bony union time and operation time, less blood loss, and larger ankle motions than conventional open reduction and plate fixation.

견관절의 결절종 제거수술후 발생한 SLAP병변

김원유,지종훈,김진영,양영준,오세철,김지창 대한견주관절의학회 2005 대한견주관절학회 학술대회논문집 Vol.2005 No.5

양극성 부분 치환된 고관절 탈구의 도수 정복중 발생한 인공골두 내측 관절면에서의 분리 - 3예 보고 -

김원유,한창환,최우성,전진성,김진영 대한정형외과학회 2002 대한정형외과학회지 Vol.37 No.2