원위 경골 및 비골에 발생한 만성 재발성 다발성 골수염

김전교(Jeon-Gyo Kim),곽희철(Heui-Chul Gwak),허민영(Min Young Her),김동균(Dong-Gyun Kim) 대한정형외과학회 2015 대한정형외과학회지 Vol.50 No.2

만성 재발성 다발성 골수염은 비감염성 염증성 골병변으로 주로 소아와 청소년에게 발생하는 질환이다. 임상적으로 모호한 골성 동통을 호소하며, 방사선학적 소견 및 조직학적 소견이 감염성 골수염과 유사하다. 또한 비교적 드문 질환으로서 다른 질환과의 감별이 어려워 종종 오진을 할 수 있다. 본원에서 11세 남아의 원위 경골 및 비골에 발생한 만성 재발성 골수염 1예를 경험하였기에 문헌 고찰과 함께 보고하고자 한다. Chronic recurrent multifocal osteomyelitis (CRMO) is a non-infectious inflammatory bone disease that occurs mainly in children and adolescents. The clinical presentation shows imprecise bone pain, while radiologic findings and histologic exam are similar to those of infectious osteomyelitis. It is a rare disease, which is difficult to distinguish from other diseases, therefore it could be misdiagnosed. We report on a case of CRMO on the distal tibia and fibula in an 11-year-old boy.

아킬레스 건염에서 스테로이드 주입 후 아킬레스 건 파열 (5예 보고)

김전교,곽희철,백종민,Kim, Jeon-Gyo,Gwak, Heui-Chul,Baik, Jong-Min 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.4

Purpose: The purpose of the study was to investigate five cases with chronic Achilles tendon rupture that occurred after steroid injections. Materials and Methods: In our hospital, we experienced five cases of chronic Achilles tendon rupture from September 2010 to March 2012. All patients had got steroid injection for Achilles tendinitis at the other hospitals, and their heel pain was aggravated when they visited our outpatient department. After treatment, signs and symptoms of Achilles tendon rupture were developed and the diagnosis was confirmed by ultrasonography or magnetic resonance imaging (MRI). Surgical treatment was done for Achilles tendon rupture. Results: There was difference between intra-operative findings of Achilles tendon rupture and usual chronic Achilles tendon rupture. Unlike usual findings of chronic Achilles tendon rupture whose scar tissue or tissue attenuation are found around the defect area of Achilles tendon, there were partial necrosis of tendon severe adhesion with surrounding tissue, extensive defect and longitudinal rupture on ruptured area. Also, severe inflammation of paratenon, granulation and fibrinoid deposit were found on biopsy findings in four cases. Conclusion: Based on review of data about relative risk and benefit of local corticosteroid injection to inflammatory lesion in Achilles tendon, it requires more attention to Achilles tendon rupture following local corticosteroid injection.

리스프랑 관절 골절 및 탈구: 나사와 Kirschner 강선을 이용한 치료

하동준,김전교,곽희철,장의찬,Ha, Dong-Jun,Kim, Jeon-Gyo,Gwak, Heui-Chul,Jang, Yue-Chan 대한족부족관절학회 2015 대한족부족관절학회지 Vol.19 No.4

Purpose: The purpose of this study is to retrospectively analyze the clinical results of screws and Kirschner wire (K-wire) fixation in patients with fracture dislocation of Lisfranc joint and the consequence of screw breakage. Materials and Methods: Sixty patients underwent Lisfranc joint open reduction and removal of internal fixators from January 2007 to December 2011. Forty-nine cases (81.7%) underwent operations with screw alone, and 11 cases (18.3%) underwent operations with both screws and K-wires. Type of internal fixators, duration of internal fixator removal, breakage of internal fixators and satisfaction with reduction were investigated. Additionally, American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scales were analyzed. Results: The internal fixator was broken in 5 cases (8.3%). The average duration of instrument removal was 154 days in the non-broken screw group and 268.6 days in the broken screw group (p<0.05). The average AOFAS midfoot scale was 77.4 in the non-broken screw group and 74.2 in the broken screw group. The most commonly damaged portion was the first tarsometatarsal (Lisfranc) joint. Conclusion: Treatment with screws and K-wires was effective in patients with fracture dislocation of Lisfranc joint. The appropriate time for screw removal should be considered.

거골하 관절에서 발생한 통풍성 관절염을 동반한 골연골종(1예 보고)

곽희철,김전교,Gwak, Heui Chul,Kim, Jeon Gyo 대한족부족관절학회 2012 대한족부족관절학회지 Vol.16 No.4

Osteochondroma, which is an osteocartilaginous exostosis, is essentially the most common primary bone tumor. These benign neoplasms are generally asymptomatic and have a relatively small potential for adverse effects. Calcaneal osteochondroma is rare, furthermore osteochondroma accompanying with gouty arthritis is very rare. Also, the subtalar joint is not a classic site of acute gout. In this report, we report the case of a patient who experienced an unusual calcaneal osteochondroma with undiagnosed gouty arthritis of the subtalar joint.

한국인 사체에서의 정상 종골의 실측: 예비보고

김정한,곽희철,김전교,정양환,Kim, Jung-Han,Gwak, Heui-Chul,Kim, Jeon-Gyo,Jung, Yang Hwan 대한족부족관절학회 2014 대한족부족관절학회지 Vol.18 No.1

Purpose: The purpose of this report is to evaluate the measured values of normal Korean calcaneus by conduct of a cadaveric study. Materials and Methods: A total of 42 calcanei were obtained from Korean cadavers. A digital goniometer was used for measurement of B$\ddot{o}$hler's angle, Gissane angle, posterior facet articular inclination angle, and Fowler-Philip angle of calcaneus. A vernier caliper was used for measurement of the maximal antero-posterior length, maximal transverse width, and maximal height of calcaneus. Results: The average B$\ddot{o}$hler's angle, Gissane angle, posterior facet articular inclination angle, and Fowler-Philip angle was $32.3^{\circ}{\pm}5.0^{\circ}$, $114.4^{\circ}{\pm}8.2^{\circ}$, $61.2^{\circ}{\pm}4.4^{\circ}$, and $60.3^{\circ}{\pm}7.6^{\circ}$. The average maximal antero-posterior length, maximal transverse width, and maximal height of calcaneus was $74.2{\pm}3.0mm$, $43.0{\pm}4.0mm$, and $42.5{\pm}3.0mm$. Conclusion: The measured values of normal Korean calcaneus were lower than the values reported in the international literature. Therefore, development of appropriate instruments reflecting the anatomical characteristics of Koreans will be needed.

아킬레스건 파열의 수술적 치료 비교: 최소 절개 봉합술과 관혈적 봉합술

공규민,곽희철,김전교,Kong, Gyu-Min,Gwak, Heui-Chul,Kim, Jeon-Gyo 대한족부족관절학회 2012 대한족부족관절학회지 Vol.16 No.3

Purpose: The purpose of this study was to compare and analyse the clinical outcomes of minimal incision repair and open repair in ruptured Achilles tendon. Materials and Methods: We retrospectively analyzed the outcomes of 10 patients with minimal incision repair (group 1) and 19 patients with open repair (group 2) from February 2007 to June 2011. The postoperative clinical evaluations were done by Arner-Lindholm scale, AOFAS score, overall patient's satisfaction and cosmetic satisfaction of scar. Results: There was no statistical difference between two groups in Arner-Lindholm scale, AOFAS score, overall patient's satisfaction (p=1.21, 0.87, 1.07). There was statistically high rate of cosmetic satisfaction in group 1(p<0.001). There were no complications in group 1. Complications occurred in three patients (deep infection, rerupture, deep vein thrombosis) of group 2. Conclusion: Treatment of minimal incision repair in Achilles's tendon ruptures showed high rate of cosmetic satisfaction and low rate of complication's, but there were no significant differences with open repair in other clinical outcomes. The minimal incision repair could be recommended as one of the effective treatment for the Achilles's tendon ruptures.

한국인 사체에서의 정상 거골의 실측

하동준,곽희철,김전교,김정한,이창락,김영준,이정한,하병호,김의철,Ha, Dong-Jun,Gwak, Heui-Chul,Kim, Jeon-Gyo,Kim, Jung-Han,Lee, Chang-Rak,Kim, Young-Jun,Lee, Jeong-Han,Ha, Byung-Ho,Kim, Ui-Cheol 대한족부족관절학회 2016 대한족부족관절학회지 Vol.20 No.4

Purpose: To investigate the measured values of the talus in Koreans. Materials and Methods: We measured 88 tali from 44 cadavers that have been donated between December 2012 and December 2015. Of the cadavers, 27 were male and 17 were female. Their mean age was 73 years. The length and width of the talus were measured using a digital goniometer and vernier caliper. Results: The values of cadaveric measurement, mean maximal width and length, width and length of the dome anterior, width and length of the posterior facet, height and length of the trochlear medial facet, and height and length of the trochlear lateral facet were $43.6{\pm}2.6mm$, $56.5{\pm}3.3mm$, $32.5{\pm}2.0mm$, $42.2{\pm}2.7mm$, $22.2{\pm}2.2mm$, $34.7{\pm}2.0mm$, $15.3{\pm}1.3mm$, $33.3{\pm}2.9mm$, $25.3{\pm}3.3mm$, and $30.8{\pm}2.4mm$ for men and $38.9{\pm}1.6mm$, $53.6{\pm}2.4mm$, $27.9{\pm}2.1mm$, $37.4{\pm}3.2mm$, $20.6{\pm}0.8mm$, $31.9{\pm}1.2mm$, $13.6{\pm}2.6mm$, $28.4{\pm}2.5mm$, $24.9{\pm}2.1mm$, and $28.9{\pm}1.4mm$ for women, respectively. The size of the talus showed an accuracy of 86% when anteroposterior diameter was greater than 59 mm. A difference in the size of the right and left talus was not observed. The mean inclination and declination angles were $24.4^{\circ}{\pm}4.2^{\circ}$ and $28.2^{\circ}{\pm}5.4^{\circ}$ for men, and $24.6^{\circ}{\pm}3.6^{\circ}$ and $24.7^{\circ}{\pm}6.7^{\circ}$ for women (p=0.980, p=0.018), respectively, at least $15^{\circ}$, which showed a big difference for every object up to $37^{\circ}$. Conclusion: This paper, to the best of our knowledge, is the first study to measure the talus in Koreans. There were differences by gender and ethnicity in the in measured talus values. The measurements were smaller than European-Americans and greater than Japanese.

회사채의 발행목적에 따른 주식시장의 정보효과에 관한 실증연구

김지수 ( Chi Soo Kim ),전교중 ( Gyo Joong Jeon ),김진노 ( Jin No Kim ) 영남대학교 산경연구소 2003 産經硏究 Vol.11 No.-

전방 십자인대 파열에 동반된 반월상 연골판 종파열의 파열부위 안정성에 따른 치료 결과

서승석,김창완,김진석,김전교,Seo, Seung-Suk,Kim, Chang-Wan,Kim, Jin-Seok,Kim, Jeon-Gyo 대한정형외과스포츠의학회 2010 대한정형외과스포츠의학회지 Vol.9 No.2

목적: 전방 십자 인대 파열에 동반된 반월상 연골판 종파열의 치료에 있어 파열 부위 안정성에 따른 결과를 임상적 평가 및 2차 관절경 소견을 통해 알아보고자 한다. 대상 및 방법: 2002년부터 2009년까지 급성 전방 십자인대 파열 및 반월상 연골판 종파열로 수술을 받은 환자 32명, 32례를 대상으로 하였다. 봉합술을 시행한 군을 제 1군, 부분 절제술을 시행한 군을 제 2군, 파열부에 안정성이 있다고 판단되어 임상적 관찰을 한 군을 제 3군으로 나누어 임상적 평가 및 2차 관절경 검사 소견을 이용해 후향적으로 비교 분석하였다. 결과: 임상적 평가로 Lysholm' score, Tegner activity score, IKDC 주관적 검사는 각 군간 통계학적 차이는 관찰되지 않았다. KT-1000 관절계는 모든 군에서 호전된 양상을 보였다. 2차 관절경 소견상 제 1군에서는 완전 치유 12례, 불완전 치유 4례, 치유 실패 1례였다. 제 2군은 절제면의 부분적 재생이 관찰되었으며, 제 3군에서는 완전 치유 4례, 치유 실패 9례로 봉합술을 시행하였다. 결론: 전방 십자인대 파열에 동반된 반월상 연골판의 종파열 시 파열부의 안정성이 유지되는 경우라도 적극적인 치료를 시도하는 것이 보다 나은 결과를 얻을 수 있을 것으로 사료된다. Purpose: The purpose of this study was to evaluate the results of treatment for longitudinal meniscal tear in ACL rupture patients by clinical evaluation and $2^{nd}$ look arthroscopy. Materials and Methods: Among the patients who underwent surgery due to ACL rupture and longitudinal meniscal tear between 2002~2009, 32 patients were selected for the study. The patients were devided into three groups; group 1 had repair, group 2 had partial menisectomy due to impossible to repair, group 3 had conservative treatment due to stable meniscus. Comparative retrospective analysis was applied with KT 1000 arthrometer, Lysolm' score, Tegner activity score, IKDC subjective score, and $2^{nd}$ look arthroscopy. Results: Lysolm' score, Tegner activity score, IKDC subjective score showed no statistical difference in all three groups. KT-1000 side to side difference improved from 6.2, 6.15, 6.38 before surgery to 2.56, 2.49, 2.58 after surgery in group 1, 2, and 3, respectively. In group 1, second-look arthroscopy revealed complete healing in 12 patients, incomplete healing without any clinical symptoms in 2, and healing failure in 1. In group 2, second-look arthroscopy showed partial regeneration on margin of meniscectomy. In group 3, second-look arthroscopy revealed complete healing in 2 patients, while 4 showed incomplete healing so that have repaired. Conclusion: In the study, the outcome was better when the stable longitudinal meniscal tear on posterior horn with ACL rupture had active treatment.

족근골 유합의 발생 빈도: 단일 기관 자기공명영상 분석

김정한,곽희철,이창락,김영준,김전교,이선주,이정한,박준호,Kim, Jung-Han,Gwak, Heui-Chul,Lee, Chang-Rak,Kim, Young-Jun,Kim, Jeon-Gyo,Lee, Sun-Joo,Lee, Jeong-Han,Park, Jun-Ho 대한족부족관절학회 2016 대한족부족관절학회지 Vol.20 No.3

Purpose: Tarsal coalition results from defects during the developmental stage and produes ankle pain and limitations in the range of motions. Its incidence has been reported to be 1%, but there has not been any reports with respect to Koreans. Therefore, we evaluated the prevalence of tarsal coalition in Koreans. Materials and Methods: Between 2005 and 2014, we analyzed a total of 733 cases of foot and ankle magnetic resonance imaging (MRI) in our hospital. There were 391 men and 342 women. All MRI readings were read by a radiologist in our hospital. We classified the coalitions in accordance with the histological and anatomical characteristics, and calculated the prevalence in each group. Moreover, we tried to determine the prevalence of tarsal coalitions in accordance with sex, age, and proportion of the symptomatic tarsal coalitions. Results: There were a total of 11 MRIs of tarsal coalition - 9 talocalcaneal coalitions, 1 calcaneocuboidal coalition, and 1 calcaneonavicular coalition. Nine tarsal coalitions were observed in men and 2 in women. Conclusion: Through this study, we found that the prevalence of tarsal coalition, including the asymptomatic patients, is similar to the previously known prevalence (1%). By getting more MRIs of the foot and ankle, we could better represent the prevalence of tarsal coalitions in Koreans.