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만성 신부전증 환자에 있어서 대퇴 사두건의 병적 파열 - 증례 보고 -
임홍철,심재학,남혁우,최병섭,홍명표 대한슬관절학회 2000 대한슬관절학회지 Vol.12 No.2
Quadriceps tendon rupture occurs most commonly in men over 50 years of age. Two thirds of these injuries are found in normal individuals. One third of patients with these injuries have significant underlying medical conditions, such as systemic lupus erythematosus, chronic renal failure, rheumatoid arthritis, obesity, gout, hyperuricemia without gout, steroid therapy, primary and secondary hyperparathyroidism, diabetes mellitus, and acidosis secondary to chronic lead nephropathy. We report 3 cases of pathologic quadriceps tendon rupture diagnosed by physical examination and confirmed by magnetic resonance imaging in 2 patients with chronic renal failure which were treated by pull-out suture through the patellar bone and augmentation with patellar tendon.
임홍철,심재학,남혁우,왕준호,노영진 대한스포츠의학회 2000 대한스포츠의학회지 Vol.18 No.2
Purpose : The medial collateral ligament injury is the most common injury of the knee. Recently Non-operative treatment has been preferred than operative treatment and most of patients have satisfactory clinical results after non-operative treatment. But a few patients have continuous instability after non-operative treatment, so the purpose of this study is to fine out the cause of persistent symptom. Methods and Materlals : We performed a retrospective study of one hundred thirty seven patients with medial collateral ligament injury treated non-operative from January 1990 to December 1997. W divided patients into two groups: isolated medial collateral ligament injury (groupⅠ): medial collateral ligament injury with concomitant anterior cruciate ligament injury (groupⅡ) and we analysed MRI finding, valgus instability, and Lysholm knee score. Result : At the follow up, three of group Ⅰ, five of group Ⅱ had persistent grade Ⅲ valgus instability. In group Ⅰ, we could find two case of rupture of the proper of medial collateral ligament with inward inversion and one case of concomitant posteromedial compartment injury. We could find the proper rupture of medial collateral ligament with inversion inward in two patients, the injury of posteromedial compartment in one patient. Two patients of group Ⅱ with grade Ⅲ valgus instability had anterior instability with laxity of grafted tendon after anterior cruciate ligament reconstruction. Conclusion : Most of isolated injury of the medial collateral ligament heals wthout operative intervention. But in case of rupture of the proper portion of medial collateral ligament with inversion inward or concomitant injury of posteromedial compartment, we should consider the operative treatment of medial collateral ligament. In case of medial collateral ligament injury with anterior cruciate ligament, it would better to consider the delicate reconstruction of anterior cruciate ligament.
족관절 후과골절의 내고정 여부에 따른 치료 결과의 비교
임홍철,전승주,나경욱,남혁우 대한외상학회 1998 大韓外傷學會誌 Vol.11 No.1
Twenty-seven trimalleolar fractures in which the posterior malleolar fragment was shown to comprise more than 25% of articular surface or displaced more than 2mm were followed for thirty-five months. Fifteen patients had the internal fixation of the posterior malleolus and twelve did not. All associated medial and lateral malleolar fractures were intemally fixed after open reduction. When satisfactory reduction of the posterior malleolus was achieved after reduction of lateral malleolus, the internal fixation of posterior fragment was not done. The results with and without internal fixation of the posterior malleolus were compared clinically and radiographically: clinically, subjective-ankle score, objective-ROM limitation were assessed and radiographically, arthritic change, posterior subluxation of talus and maintenance of the posterior malleolus without fixation were assessed. Radiographically, further displacement of posterior malleolus were noted in two cases in without fixation group. There were four arthritic changes in fixation group and three in without fixation group. Posterior subluxation of talus was not occurred in two groups. In the clinical results with and without internal fixation of posterior malleolus, there was no statistically significant diffrence in two groups.