Supplementary Technique for Unstable Clavicle Shaft Fractures: Interfragmentary Wiring and Temporary Axial K-Wire Pinning

단진명,김병국,이호재,김태호,김용근 대한정형외과학회 2018 Clinics in Orthopedic Surgery Vol.10 No.2

Background: Treatment of unstable clavicle fractures remains a challenge for orthopedic surgeons, but the evolution of treatment strategies has allowed for reliable results with minimal complications. Although several surgical options exist, open reduction with plating remains the treatment of choice for clavicle fractures. The purpose of this study is to determine an easy way to achieve successful preplating reduction while minimizing surrounding soft tissue damage during treatment of midshaft fractures of the clavicle. Methods: A retrospective study included all consecutive adult patients operated on by a single surgeon for acute displaced clavicular midshaft fracture between January 2010 and October 2014. Hybrid technique with interfragmentary cerclage wiring, temporary axial K-wire pinning, or their combination was used in all patients. The demographic data and clinical outcomes, including operation time, union time, restoration of anatomy, shoulder functional score, and complications were evaluated. Results: There were 54 male and 19 female patients, with an average age of 39.3 years (range, 18 to 77 years) for males and 58.3 years (range, 39 to 77 years) for females. They were followed up for 24 months (range, 12 to 44 months). All patients had reliable bone union after surgery using interfragmentary cerclage wiring and temporary axial K-wire fixation; fracture union was obtained at an average of 11.7 weeks (range, 8 to 21 weeks) postoperatively. Additionally, there was no postoperative loss of fracture reduction or plate loosening. At the final follow-up, all patients had regained excellent functional outcomes. Conclusions: The cognizant effort to achieve anatomic reduction without surrounding soft tissue insult before definitive plating allows excellent radiologic and functional outcomes. Interfragmentary cerclage wiring and temporary axial K-wire pinning can overcome difficulties associated with unstable clavicle fractures to allow proper fracture reduction. In this article, we introduce a concise technique for achieving the desired outcomes reliably and efficiently when treating unstable clavicle midshaft fractures.

Arthroplasty vs. ORIF in osteoporotic fracture of elderly patient

단진명 대한견주관절의학회 2022 대한견주관절학회 학술대회논문집 Vol.2022 No.11

Complicated Case of Middle Age Man Shoulder Dislocation

단진명 대한견주관절의학회 2012 대한견주관절학회 학술대회논문집 Vol.2012 No.11

근위 상완골 골절에서 삼각 대흉간 도달 법과 삼각근 분할 도달법 간의 임상적, 방사선학적 추시 결과 비교

단진명,김병국,이윤석,김형종,이진현,김재화 대한견주관절의학회 2012 대한견주관절학회 학술대회논문집 Vol.2012 No.11

미세 수술 후 처치

단진명,한수홍,Dan, Jin Myoung,Han, Soo Hong 대한미세수술학회 2012 Archives of reconstructive microsurgery Vol.21 No.2

흑인 여성에서 발생한 밴드형 말단골용해: 증례 보고 및 문헌 고찰

단진명,하청수,이호재 대한수부외과학회 2022 대한수부외과학회지 Vol.27 No.1

Acro-osteolysis is a bone resorption reaction that progresses slowly in the distal phalanx of the hand and foot and is associated with various diseases. It can be classified as idiopathic or secondary. Although the mechanism of acro-osteolysis has not been fully elucidated, the presence of a chronic ischemic injury appears to have a significant effect, and bone metabolism dysregulation due to the accompanying calcinosis or peripheral neuropathy also appears to contribute. Acro-osteolysis can show various clinical and radiological features, and the differential diagnosis of the underlying etiology is essential. It is a rare and sporadic disease worldwide. The authors experienced a case of acro-osteolysis suspected of idiopathic cause in a Black woman; therefore, we report this case with a literature review.

Vaccine related acute resorption of Quiescent Chronic Calcific Tendinitis

단진명(Jinmyoung Dan),송원태 대한견주관절의학회 2014 대한견주관절학회 학술대회논문집 Vol.2014 No.3

대퇴골두 골단분리증의 치험례

단진명,김세동 영남대학교 의과대학 1997 Yeungnam University Journal of Medicine Vol.14 No.1

저자들은 1989년 1월부터 1995년 7월까지 영남대학교 의과대학 부속병원 정형외과에서 대퇴골두 골단분리증으로 입원하여 수술적 치료를 받았던 10명(12고관절)의 환자의 치료 경험을 통하여 다음과 같은 결과를 얻었다. 1. 남녀성비는 6:4 였으며, 수술시 평균 나이는 11.8세였다. 발병부위는 좌측이 7례, 우측이 1례, 양측이 2례였다. 2. 임상적 유형별로는 급성분리가 2례(2고관절), 만성분리에 겹친 급성분리가 5례(6고관절), 만성분리가 3례(4고관절)였다. 3. 방사선 소견상 대퇴부경부에 대한 골두의 전위정도를 기준으로 하였을때, 경도의 분리가 7례(9고관절), 중등도의 분리가 1례, 고도의 분리가 2례였다. 4. 10례의 환자중 5례에서 비만에 성발육 지연을 보였고, 세장형의 환자가 2례였고, 정상 체형은 3례였다. 5. 10례중 5례에서 외상의 병력이 있었고, 1명에서 연소기 류마토이드 관절염의 병력이 있었다. 6. 내분비계 검사를 시행한 6명의 환자에서 모두 유증상 또는 무증상의 호르몬이상을 볼 수 있었다. 7. 수술적 방법으로 9례(11고관절)에서 정위치핀고정술을 실시하였고, 고도분리된 1례에서 절골술후 핀고정술을 실시하였다. 8. 환자들의 최종추시때의 고관절의 기능은 excellent가 6례(8고관절), good이 2례, failure는 2례였다. failure 2례는 술후합병증으로 대퇴골두무혈성괴사가 속발한 경우였다. 대퇴골두 골단분리증은 청소년기의 비교적 드문 고관절질환으로 치료시 연골 용해증 및 대퇴골두 무혈성 괴사등 심각한 합병증을 동반할 수 있으나, 정위치 핀고정술로 대부분 goood 이상의 결과를 얻을 수 있었다. 또한 이 질환에서 증상이 있는, 또는 이 질환에서 내분비계의 이상을 동반하는 경우가 많으므로 진단시 호르몬 이상유무를 검사해야하고, 이상이 있는 경우에는 보다 장기적인 추시관찰이 필요할 것으로 사료된다 Slipped capital femoral epiphysis (SCFE) is a disorder in which there is a gradual of acute disruption through the capital physeal plate. The pyhsiolysis is through a widened zone of hypertrophy, which is weakened due to altered chondrocytic maturation and endochondral ossification. The cause or causes of SCFE remain uncertain. The assocoation of obesity and adolescent age with growth rate are predisposing factors. The possibility that most patients with subclinical hormonal abnomality were proved. The goal of treatment of slipped capital femoral epiphysis is to restore the function of the hip and delay the development of degenerative osteoarthrosis by prevention of additional displacement of the epiphysis. We report 10 patients (12hips) with SCFE who were treated by surgical means and followed along for more than one year, at Yeungnam University Hospital, from 1989 to 1996. There were six boys and four girls. The average age at operation was 11.8 years. Seven cases occurred in the left hip, one case in the right and 2 cases had bilateral involvement, five cases had a history of minor trauma on affected hip. Among hormonally studied six patients, panhypopituitarism patient was one case; decreased testosterone, two; decreased growth hormone, two; and decreased thyroid hormone, one. According to clinical stage, two cases were the acute type; five cases, acute on chronic thpe; and three cases, chronic type. On the radiological grades of slipping, mild slippage were nine hips; moderate, one ; and severe, two. The eleven hips were treated by pin fixation in situ, and one, by cuneiform osteotomy. On the average follow-up of 2.6 years, ten hips were excellent or good functional results, two hips were failure.

Treatment of Thoracolumbar Fracture

김병국,단진명,신동은 대한척추외과학회 2015 Asian Spine Journal Vol.9 No.1

The most common fractures of the spine are associated with the thoracolumbar junction. The goals of treatment of thoracolumbar fracture are leading to early mobilization and rehabilitation by restoring mechanical stability of fracture and inducing neurologic recovery, thereby enabling patients to return to the workplace. However, it is still debatable about the treatment methods. Neurologic injury should be identified by thorough physical examination for motor and sensory nerve system in order to determine the appropriate treatment. The mechanical stability of fracture also should be evaluated by plain radiographs and computed tomography. In some cases, magnetic resonance imaging is required to evaluate soft tissue injury involving neurologic structure or posterior ligament complex. Based on these physical examinations and imaging studies, fracture stability is evaluated and it is determined whether to use the conservative or operative treatment. The development of instruments have led to more interests on the operative treatment which saves mobile segments without fusion and on instrumentation through minimal invasive approach in recent years. It is still controversial for the use of these treatments because there have not been verified evidences yet. However, the morbidity of patients can be decreased and good clinical and radiologic outcomes can be achieved if the recent operative treatments are used carefully considering the fracture pattern and the injury severity.

The surgical outcomes of the articular shear fractures of the distal part of the humerus

신동주,단진명,이성만,변영수,김성욱 대한견주관절의학회 2011 대한견주관절학회 학술대회논문집 Vol.2011 No.3