변형 마우 절골 술기의 유용성과 한계점 (30예 추시 보고)

배서영,김병민,남희태,최희준,Bae, Su-Young,Kim, Byoung-Min,Nam, Hee-Tae,Choi, Hee-Joon 대한족부족관절학회 2008 대한족부족관절학회지 Vol.12 No.1

Purpose: To evaluate the value and limitation of modified Mau osteotomy through the review of 30 feet treated by this procedure. Materials and Methods: We retrospectively analyzed 30 cases treated with modified Mau osteotomy since 2002. The mean duration of follow-up was 10 months. We reviewed medical records to describe each case and select several clinical factors which related with surgical procedure and could influence on final results. We measured radiographic parameters such as hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), sesamoid position and also assessed clinical outcomes by AOFAS score and satisfaction degrees. Results: The mean preoperative HVA and IMA were $40.4^{\circ}$, $17.4^{\circ}$ and the mean amounts of correction were $31.2^{\circ}$ and $11.5^{\circ}$. Amounts of delayed loss of correction were 16.8% in HVA and 19.2% in IMA. Initial HVA, rotational angle and translation distance of the distal fragment, stability of fixation, first ray instability were revealed as significant factors for the final result from this procedure. DMAA was increased by rotation of the distal fragment and decreased by adding translation on the rotation. Conclusion: Modified Mau osteotomy is an effective procedure to get enough correction. But, it is important to try to avoid excessive rotation of the distal fragment because it may worse joint congruity. It may be worthwhile to pay close attention to the direction of saw and stability of fixation.

흡수성 봉합사만를 이용한 아킬레스건 파열의 수술적 치료

배서영,박재구,정의엽,Bae, Su-Young,Park, Jae Gu,Jung, Eui Yub 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.3

Purpose: To report the clinical results from using absorbable suture materials instead of nonabsorbable materials which have been used more commonly to repair Achilles tendon. Materials and Methods: We retrospectively reviewed 21 cases of acute Achilles tendon rupture, treated surgically from 2004 to 2011. Mean follow-up period is 6 months. We repaired Achilles tendon using size 1 Vicryl (Polyglactin 910, Ethicon) for core suture and size 3-0 Vicryl for epitendinous suture. At three months after surgery, we evaluated clinical results with single heel raise height by centimeters, differences of calf circumference and passive range of motion of ankle joint, compared to contralateral side. Also we recorded clinical results with subjective satisfaction grades. Results: At three months after surgery, 20 of 21 patients were able to perform single heel raise over 5 cm in height. Calf circumference differences were less than 1 cm in 12 cases, between 1 cm to 3 cm in 5 cases, more than 3 cm in 4 cases. There was no difference in range of passive motion in 19 cases. All patients satisfied with daily activity except 2 cases with mild discomfort. There was no complication such as rerupture, elongation or infection. Conclusion: We experienced excellent clinical results from repairing Achilles tendon with using absorbable suture materials in terms of functional outcomes and patient's satisfaction without any complication. So we may consider using absorbable suture materials instead of nonabsorbable materials to repair Achilles tendon.

족부의 말초 신경 병변으로 인한 통증에서 피리독신의 사용

배서영,정의엽,오수찬,Bae, Su-Young,Jung, Eui Yub,Oh, Su Chan 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.3

Purpose: We analyzed retrospectively the effect of pyridoxine in the treatment of peripheral nerve related foot pain because we have seen favorable clinical results from it as a monotherapy. Materials and Methods: We analyzed the clinical results of 200 cases of peripheral nerve related foot pain, treated with pyridoxine from March 2009 to February 2012. We devided them into three groups, peripheral neuritis, Morton's neuroma and posttraumatic neuralgia and recorded percentage of improvement of pain, compared to initial pain level at 2 weeks and 6 weeks. Results: There were 127 peripheral neuritis cases, 22 Morton's neuroma and 51 posttraumatic neuralgia. At 2 weeks after treatment, 135 cases(67.5%) showed pain relief. At 6 weeks, 36 cases(21%) showed complete improvement of pain, 81 cases(47%) showed more than 50 % of improvement, 22 cases(13%) showed less than 50% of improvement and 33 cases(19%) showed no improvement. There are 4 cases of gastrointestinal discomfort and 2 cases of aggravation of nervy pain. Conclusion: Pyridoxine was effective drug in the treatment of peripheral neuropathic pain in terms of pain relief, safety and cost effectiveness. So it can be an available first line drug before adding other drugs.

벽매립형 중앙 흡인장치를 이용한 감염성 당뇨병성 족부 궤양의 밀봉 치료

배서영,이창욱,서인석,Bae, Su-Young,Lee, Chang-Wook,Seo, In-Seock 대한족부족관절학회 2004 대한족부족관절학회지 Vol.8 No.1

감염된 당뇨병성 족부궤양의 병실내 벽매립형 중앙 흡인 장치를 이용한 창상 밀봉관리로 빠른 창상의 호전을 얻을 수 있었다. 이 창상관리 방법은 빠른 창상의 호전 외에도 비용을 획기적으로 줄일 수 있으며 환자의 동통을 줄이고 병실내 세균 전파의 위험이 적으며 필요 인력 축소 등의 장점이 있으나 말기신장부전 환자에서의 적용은 추가의 연구가 필요할 것으로 사료된다. Purpose: The infected diabetic foot patients were reviewed to analyze the result of new dressing methods using a wall-suction instruments. Materials and Methods: Eighteen patients treated with wall-suction assisted vacuum dressing were included. After debridement under local anesthesia, a sponge pad, a drain, and a surgical drape were used to seal the wound. Negative pressure applied by the wall-suction at around 200 mmHg and dressing were repeated in every two to three days. The results of repeated wound cultures, growth of granulation tissues, and CRP level were closely observed on the regular basis. Results: Rapid growth of granulation tissues was noticed around the wound in 16 cases. No organism was obtained in an average 5 days and wound coverage was possible in an average 18 days. The CRP level returned to normal in an average 4 weeks. Two patients with end stage renal disease, who were regularly hemodialised, underwent major amputation. Conclusion: New dressing method has the following advantages: a rapid wound improvement in the patients with infected diabetic foot, less expensive, less painful, impediment of bacterial contamination in the hospital room. However, further study will be needed for the end stage renal disease patients.

유전성 연축성 양하지 마비 환자에서의 족부 진행성 동적 첨내반족 -1예 보고-

배서영,서인석,Bae, Su-Young,Seo, In-Seock 대한족부족관절학회 2004 대한족부족관절학회지 Vol.8 No.1

In neurogenic equinovarus deformity, surgical intervention such as tendon transfer or osteotomy can be expected to improve symptoms. However, in rare cases of hereditary spastic paraplegia, the deformity and paralysis gradually progress. So limited operation and early post-operative rehabilitation are preferred to aggressive operation. We would like to report our clinical experience with one case of hereditary spastic paraplegia patient with reference review. A 40 year-old male, given tendon transfer of ankle and foot and tendo achilles lengthening 10 years ago, complained about aggravated spastic paraplegia which resulted in dynamic equinovarus and limited walking ability since his operation. Family history showed limited walking ability of his father with gradually progressing spastic paralysis and he was diagnosed as hereditary spastic paraplegia type I. We had performed a limited operation such as tendo achilles and tibialis posterior lengthening to induce plantigrade standing and walking with crutch. As a result, the patient was able to maintain a stabilized standing posture and walk after the operation. Hereditary spastic paraplegia presents with a progressive paralysis which limits rehabilitation after tendon transfer, and the symptoms can be aggravated. Therefore, considering potential hereditary neurogenic disorders in paients with equinovarus deformity and performing limited operative procedures seem to be important.

아베 고보의 제4간빙기 론 - 비현실 묘사를 통한 현실 인식을 중심으로 -

배서영 대한일어일문학회 2019 일어일문학 Vol.84 No.-

Kobo Abe’s “Inter Ice Age 4” is estimated as the first serious full-length SF novel in Japan. There are not many theses on the novel, and in most of the cases, the studies have focused on scientific materials portrayed in the work, on analysis of the main characters, ‘I’ and his assistant Yoriki, or on the aquatic boy in the future forecast. Thus, this paper studies the novel focusing on animals, fetus, and the woman providing the fetus that are victimized in the surreal portrayal of aquatic human engineering. It is because I think the issues of lack of animal ethics, abortion regarding Eugenic Protection Law, and women’s social position stand out in “Inter Ice Age 4”. The structure where an organization named ‘Undersea Development Society’, which intervenes in the private lives of individuals and controls their lives, builds alliances with and assists the government in order to accomplish their purpose reflects the Japanese officials and the financial leaders who set forth abortion as a measure, worrying the economic benefits would be encroached upon after Japan had lost World War 2. Though the aquatic human society portrayed in the future forecast and the present society in the novel have different social systems, communism and democracy respectively, they have it in common that they oppress individuals and restrictively share information to achieve certain purposes. From this, we can figure out the novel brings up the problem that those in power victimize those put in relatively weak positions and use them as a means regardless of what system the society has.

거골의 골연골병변: 자가 골연골 이식술

배서영 대한족부족관절학회 2020 대한족부족관절학회지 Vol.24 No.2

Among the various surgical treatment methods for osteochondral lesions of the talus, autologous osteochondral transplantation (AOT) is a useful procedure in cases of a large defect, subchondral cyst, and failed primary bone marrow stimulation procedure. Although bone marrow stimulation alone may not regenerate the damaged plate sufficiently, AOT has the advantage of being able to replace the subchondral bone plate and cartilage with a new one at a same time. Nevertheless, postoperative cyst formation or pain may persist and donor site morbidity is still a limitation of AOT.

급성 아킬레스건 파열의 치료 동향: 대한족부족관절학회 회원 설문조사 분석

배서영,조재호,조병기,정형진 대한족부족관절학회 2022 대한족부족관절학회지 Vol.26 No.2

Purpose: This study was based on the Korean Foot and Ankle Society (KFAS) member survey and aimed to report the current trends in the epidemiology, diagnosis, and management of acute Achilles tendon rupture (AATR) over the past few decades. Materials and Methods: A web-based questionnaire containing 34 questions was sent to all KFAS members in October 2021. The questions were mainly related to the clinical experience and preferred management of patients with AATR. Answers with a prevalence ≥50% of the respondents were considered a tendency. Results: Seventy-one (12.9%) of the 550 members responded to the survey. The male sex ratio in AATR was answered mean 78%, and the most common age groups were 30~40 years (n=49; 69.0%), and 40~50 years (n=37; 52.1%), in that order. The most common seasons for the occurrence of AATR were spring (37 cases; 52.1%) and autumn (27 cases; 38.0%). Also, sports-related rupture had an average occurrence of 76.2%. The most important clinical factor to determine the type of treatment was the history of previous injuries, and 75.9% of respondents started conservative treatment in the 2010s. The most preferred protocol of conservative treatment was an orthosis capable of ankle range of motion after casting (68.5%), and 53.7% ‘satisfied’ and 1.9% ‘very satisfied’ with conservative treatment. The most preferred surgical method was open repair (80.3%), and the Krackow method (60.6%), and 49.3% of treated patients responded ‘satisfied’ and 45.1% ‘very satisfied’ with this treatment. Conclusion: This study gives updated information concerning the current trend of epidemiology, diagnosis, and treatment of AATR in Korea. Both consensus and variation in the approach to AATR were identified using this survey study. This study may raise the awareness of various possible approaches toward AATR and should be used to further establish a standard protocol for the management of this injury.

신연 외고정 및 지속적 반수동 운동을 이용한 경골 원위부 필론 골절의 치료

배서영,정형진,신용운,박재구,Bae, Su-Young,Chung, Hyung-Jin,Shin, Yong-Woon,Park, Jae-Gu 대한족부족관절학회 2010 대한족부족관절학회지 Vol.14 No.2

Purpose: Pilon fracture has several serious complications such as joint stiffness, arthrosis and delayed angular deformity. We report short-term results of new treatment modality using distracted dynamic external fixators and early controlled ankle motion. Materials and Methods: Eight cases of severe pilon fractures for which we tried small plate fixation and additional distracted dynamic external fixators from July 2007 to June 2009 were included. Half passive continuous ankle joint motion was allowed under free hinged ring fixators after the operation. The external fixators were removed after two or three months from the surgery. We investigated joint space by radiograph, joint pain, range of motion, patient's satisfaction of treatment protocol. Results: Joints were distracted when external fixators were applied and mean 28% of space loss developed after removal of external fixators. In most of cases, satisfactory alignments were maintained. Regarding range of joint motion, mean dorsiflexion angle was 15 degrees and mean plantarflexion angle was 32 degree in the condition of wearing external fixators. There was mean 8% reduction of range of motion but no further progression of ankle stiffness after removal of external fixators. Dorsiflexion was not improved after that, but plantarflexion angle was improved 10% even after removal of external fixators. Patients were generally in compliance with the treatment protocols with high level of satisfaction. Conclusion: We got good results with distracted dynamic external fixators and early continuous half-passive joint motion for pilon fractures in terms of joint pain and range of motion. Therefore we suggest this new protocol as an alternative modality for severe pilon fractures.

수술 중 부하 영상을 이용한 원위 경비 관절 손상 진단 방법의 평가

배서영,정형진,오수찬,Bae, Su-Young,Chung, Hyung-Jin,Oh, Su-Chan 대한족부족관절학회 2011 대한족부족관절학회지 Vol.15 No.1

Purpose: To report the effectiveness of adding distal fibular external rotation stress test on the traditional lateral stress Cotton test in evaluating distal tibiofibular syndesmotic injuries. Materials and Methods: We evaluated syndesmotic injuries with intraoperative stress test during treating ankle fractures from March 2009 to September 2010. External rotation of distal fibula using small elevator was added on traditional stress test in case of suspicious syndesmotic injury. We retrospectively reviewed and compared the results of each test in 44 cases for which we tried both tests. Results: In 9 cases of positive traditional lateral stress tests, positive results were obtained in all cases by additional external rotation tests. In 21 cases of negative traditional stress tests, additional stress tests results were also negative. But there were 10 cases of positive additional tests and 4 of negative additional tests in equivocal results cases by the traditional stress tests. Conclusion: Using additional external rotation stress test in case of equivocal test result by the traditional lateral stress Cotton test for evaluation of syndesmotic injury during operation for ankle fracture can be a supplemental method to clarify syndesmotic injury needs fixation.