스폰지 겸자를 이용한 아킬레스건의 최소 절개 봉합술: 술기 보고

박삼국,박철현,Park, Sam Guk,Park, Chul Hyun 대한족부족관절학회 2016 대한족부족관절학회지 Vol.20 No.2

Various minimally invasive repair techniques have been performed for acute Achilles tendon rupture. Despite this, it is difficult to use these techniques in common practice because of the necessity of special instruments. We propose a novel minimal invasive technique using sponge holding forceps, which are commonly used in the operating room for the acute Achilles tendon rupture.

중족족근관절의 골극으로 인해 발생한 제 2, 3장족지 신전건의 자연적 파열: 증례 보고

박삼국,박철현,Park, Sam Kook,Park, Chul Hyun 대한족부족관절학회 2016 대한족부족관절학회지 Vol.20 No.1

Spontaneous rupture of the extensor tendon has been reported in association with predisposing inflammatory conditions including rheumatoid arthritis, diabetes, trauma, tophaceous gout, and steroid injection. The authors experienced a case of spontaneous rupture of the extensor digitorum longus tendons caused by an osteophyte of the tarsometatarsal joint in a patient with rheumatoid arthritis. The authors stress that aggressive treatment including surgery could be considered for prevention of spontaneous tendon rupture in a patient with predisposing conditions despite an asymptomatic spur.

Could immediate treatment change the management method of digital tendon musculotendinous junction avulsion?: a systematic review

박삼국 영남대학교 의과대학 2017 Yeungnam University Journal of Medicine Vol.34 No.2

Background: We conducted a systematic review of the literature to investigate the correlation between the interval to treatment and management of tendon avulsion ruptures in the musculotendinous junction (MTJ) of the forearm. Methods: A thorough literatures search for studies of tendon avulsion injuries at the forearm was conducted using PubMed, MEDLINE, CINAHL, and Cochrane databases in accordance with the PRISMA guidelines. In total, five case series and 15 case reports accounting for 87 injured tendons involving 60 patients were selected for the analysis. Results: Twenty-six patients had 44 tendon injuries associated with avulsion amputations, 31 patients had 38 tendon ruptures associated with closed avulsion injuries and three patients had five tendon ruptures associated with open avulsion injuries. Eighteen of the 49 (37%) patients were immediately treated for tendon ruptures and one of the 32 (3%) tendon ruptures treated via elective surgery was directly repaired. Additionally, 18 of the 30 (60%) tendons were directly repaired and 12 of the 30 (40%) tendons were transferred or side-to-side repaired in the immediately treated series. In contrast, one of the 28 (4%) tendon ruptures were directly repaired and 27 of the 28 (96%) tendons were transferred or side-to-side repaired in the electively treated series. Conclusion: In managing digital tendon avulsions at the MTJ, an immediate treatment could provide an opportunity to repair the ruptured tendon directly to the muscle

Analysis of implants for total elbow replacement

박삼국 대한견주관절의학회 2022 대한견주관절학회 학술대회논문집 Vol.2022 No.11

외상 후 무지 수근중수관절의 만성 불안정성: 3예 보고

박삼국,고영진 대한수부외과학회 2016 대한수부외과학회지 Vol.21 No.4

Posttraumatic instability of the carpometacarpal joint of the thumb are rarely reported. Consequently little is known about clinical and radiologic diagnosis, natural progress or treatment method. We report three cases of chronic instability of the carpometacarpal joint of the thumb treated with Eaton and Littler’s ligament reconstruction. Satisfactory thumb functions were restored without arthritic change or recurrent subluxation. 무지 수근중수관절의 외상 후 불안정성에 대해서는 보고가 드물고, 그 결과 임상적, 영상의학적 진단 방법, 자연 경과, 그리고 치료 방법에 대해 잘 알려져 있지 않다. 저자들은 외상 후 보존적 치료 후에 무지 수근중수관절의 만성 불안정성이 발생한 3예를 Eaton과 Littler의 전방경사인대 재건술을 이용하여 치료하였다. 3예 모두 퇴행성 변화나 불안정성의재발 없이 만족스러운 무지 기능의 회복을 얻었기에 문헌 고찰과 함께 보고하는 바이다.

Free Vascularized Medial Femoral Condyle Bone Graft for Scaphoid Nonunion with Poor Prognosis Factors

박삼국,심범진,석현규 대한수부외과학회 2021 대한수부외과학회지 Vol.26 No.2

Purpose: Authors attempt to evaluate the clinical and radiographic results of the treatment of scaphoid nonunion with poor prognostic factors with the free vascularized medial femoral condyle bone graft. Methods: We operated on eight patients with avascular necrosis or prolonged nonunion of the scaphoid between January 2016 and July 2019. Wrist motion in terms of flexion, extension, and ulnar and radial deviation, a visual analogue scale (VAS), the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the modified Mayo wrist score, scapholunate angle, and carpal height index were collected in the clinic setting preoperatively and at the latest follow-up in all patients Results: Eight patients with union achieved correction and maintenance of both scapholunate angle and carpal height index. The VAS pain scores significantly improved from 5.1 preoperatively to 3.3 postoperatively. There was a statistically significant improvement in the average DASH score at the final follow-up. Scapholunate relationships in the reconstructed wrists remained almost unchanged, with average scapholunate angles of 49.7° before surgery and 47.0° at the latest postoperative follow-up. There was no statistical significance between the number of poor prognosis factors and the time to union, but there was a positive correlation. Conclusion: It could help surgeons manage the scaphoid nonunion associated with poor prognostic factors such as avascular necrosis, carpal collapse (posttraumatic arthritis), prolonged nonunion, and failed prior scaphoid nonunion surgery.

Tarsal Tunnel Syndrome Associated with Gout Tophi: A Case Report

박삼국,박철현,안효세 대한족부족관절학회 2016 대한족부족관절학회지 Vol.20 No.2

Tarsal tunnel syndrome is an entrapment neuropathy of the posterior tibial nerve or its branches in the fibro-osseous tunnel beneath the flexor retinaculum. This pathology is associated with multiple etiologies, including trauma, space-occupying lesions, and impaired biomechanics. We report a case of tarsal tunnel syndrome associated with gout tophi in a patient with untreated gout along with a review of the relevant literature on tarsal tunnel syndrome.

골유합 부전의 대사적, 역학적 원인

박삼국 ( Sam-guk Park ),손욱진 ( Oog Jin Shon ) 대한골절학회 2017 대한골절학회지 Vol.30 No.1

불유합은 골절 치료 후 가장 우려되는 합병증의 하나로 환자 및 의사들이 결과를 알 수 없는 긴 치료를 견뎌내야 하는 인내를 요구하게 한다. 저자들은 불유합의 위험인자에 관한 문헌을 고찰하여 골절 간격, 안정성, 골괴사와 유합 기전, 골다공성 골절과 고정 방법, 골절의 양상, 연부조직 손상, 국소감염, 다발성 골절과 같은 역학적 인자와 나이, 동반 이환, 흡연, 알코올 중독, 약물과 같은 대사적 인자에 관한 최근 경향을 살펴보았다. 불유합의 원인을 조금씩 알게 되면서 내고정 기구 및 수술 방법에서 많은 발전이 지속되고 있고, 대사적 인자의 작용 기전에 관한 지식도 넓어지면서 불유합의 복합적 치료 방법이 각광을 받고 있다. 골절 및 불유합 치료 시 위험인자와 치료에 있어서의 발전된 부분을 고려하여 더 좋은 계획을 세울 수 있기를 바라는 바이다. Non-union is one of the most devastating complications after fracture fixation. It usually results in prolonged treatment duration and unpredictable results. We reviewed the literature to identify recent information regarding the following: risk factors of nonunion; mechanical risk factors, including fracture gap width and stability, osteonecrosis and healing mechanism, osteoporotic fracture and fixation method, the characteristics of fracture, soft tissue injury, local infection, and multiple fractures; as well as the metabolic risk factors, including age, comorbidities, smoking, alcoholism, and medications. The technique and devices for fracture treatment have been developed, and treatments of nonunion are evolving according to the enhancement of our understanding of nonunion. Clinicians should refer to the risk factors and advancements while developing a treatment plan.

골다공성 상완골 근위부 분쇄골절에 대한 내외측 이중 금속판 내고정술 -2예 보고-

박삼국 ( Sam Guk Park ) 대한골절학회 2016 대한골절학회지 Vol.29 No.1

골다공증성 또는 내측 골간단부 분쇄가 동반된 고령의 상완골 근위부 분쇄 골절의 경우 외측 잠김 압박 금속판을 사용하여도 견고한 고정을 얻기 어려운 경우가 있어 치료 방법에 대하여 논란이 되고 있다. 저자는 골다공증이 동반된 고령의 환자에서 내측 골간단부 분쇄가 동반된 불안정성 상완골 골절에 전 상완 회선 동맥이 파열되어 있고, 외측 잠김 나사 금속판 고정 후에도 견고한 내고정을 얻지 못한 경우 추가적으로 내측지지 금속판 고정으로 견고한 고정을 얻어 조기에 견관절 운동을 허용할 수있었다. 고정 상실 없이 순조로운 유합을 얻었으며, 우려했던 상완골 두 무혈성 괴사 없이 견관절의 기능은 만족스럽게 회복되었음을 보고하는 바이다. Some proximal humeral fractures in elderly patients are accompanied by medial metaphyseal comminution and quality of the bone is so poor that head preserving osteosynthesis seems to be amenable. In cases of medial metaphyseal comminution, lateral locking compression plate (LCP) fixation also has a tendency to become a matter of screw cut out or loss of fixation. The author reports on successful treatment of two osteoporotic proximal humeral fractures combined with medial metaphyseal comminution, with application of additional direct medial supporting plate fixation. Medial plate fixations were added when the fractures were still unstable after the conventional lateral LCP fixation and anterior circumflex humeral arteries had been ruptured before. The fixations were stable enough to start exercise immediately after surgery. The inclinations of the humeral neck were not changed until the last follow-up and clinical results were satisfactory without humeral head osteonecrosis which was a concern.

불안정성 상완골 근위부 골절에서 내측 지지 금속판 고정술

박삼국(Park Sam-Guk),고영진(Ko Young-Jin) 대한견주관절의학회 2018 대한견주관절학회 학술대회논문집 Vol.2018 No.3