노인의 상완골 경부 골절 불유합의 수술적 치료

백구현,정문상,이상훈,권봉철,하정현 대한정형외과학회 2003 대한정형외과학회지 Vol.38 No.2

Long-term Outcomes of Ulnar Shortening Osteotomy for Idiopathic Ulnar Impaction Syndrome: At Least 5-Years Follow-up

백구현,Hyuk Jin Lee,Hyun Sik Gong,Seung Hwan Rhee,Jihyeung Kim,Kang Wook Kim,Bong Young Kong,Won Seok Oh 대한정형외과학회 2011 Clinics in Orthopedic Surgery Vol.3 No.4

Background: There have been few outcomes studies with follow-up after performing ulnar shortening osteotomy for ulnar impactionsyndrome. We investigated the long-term clinical and radiological outcomes of ulnar shortening osteotomy for the treatmentof idiopathic ulnar impaction syndrome. Methods: We retrospectively reviewed 36 patients who had undergone ulnar shortening osteotomy for idiopathic ulnar impactionsyndrome for a mean follow-up of 79.1 months (range, 62 to 132 months). The modifi ed Gartland and Werley scores were measuredpre- and postoperatively. The radiographic parameters for the assessment of the distal radioulnar joint (DRUJ) as well as therelationship between these radiographic parameters and the clinical and radiological outcomes were determined. Results: The average modifi ed Gartland and Werley wrist score improved from 65.5 ± 8.1 preoperatively to 93.4 ± 5.8 at the lastfollow-up visit. The average preoperative ulnar variance of 4.7 ± 2.0 mm was reduced to an average of −0.6 ± 1.4 mm postoperatively. Osteoarthritic changes of the DRUJ were fi rst seen at 34.8 ± 11.1 months follow-up in 6 of 36 wrists (16.7%). Those whohad osteoarthritic changes in the DRUJ had signifi cantly wider preoperative ulnar variance, a longer distal radioulnar distance anda greater length of ulnar shortening, but the wrist scores of the patients who had osteoarthritic changes in the DRUJ were comparableto those who did not have osteoarthritic changes in the DRUJ. Conclusions: The clinical outcomes are satisfactory for even more than 5 years after ulnar shortening osteotomy for treating idiopathiculnar impaction syndrome despite the osteoarthritic changes of the DRUJ. The patients who need a larger degree of ulnarshortening may develop DRUJ arthritis.

Classifi cation and Surgical Treatment of Symphalangism in Interphalangeal Joints of the Hand

백구현,Hyuk Jin Lee 대한정형외과학회 2012 Clinics in Orthopedic Surgery Vol.4 No.1

Background: Symphalangism is a rare congenital difference characterized by ankylosis of interphalangeal (IP) joints of the fi ngersand toes. In adults, there were several attempts to restore the stiff joints into mobile ones, but these treatment options resultedin poor outcomes and could not be applied to growing children. Here, we report our experiences on surgical treatment for childrenwho had symphalangism of the hand. Methods: We treated 36 joints in 17 children with symphalangism of the hand using dorsal capsulotomy and collateral ligamentrelease. The diagnoses were based on history, physical examination, and simple radiographs. Affected fi ngers were classifi ed accordingto our grading system. Simple compressive dressing was applied using Coban after surgery. Passive range of motion (ROM)exercise was started on day one or 2 postoperative, with the help of a hand therapist and patients’ parents. The patients wereprescribed passive ROM exercises for at least 2 hours a day over a period of 6 months. Results: A single surgeon operated on 30 proximal IP joints, 3 distal IP joints, and 3 IP joints of the thumb. Twenty six joints wereclassifi ed as grade I, and 10 as grade II. The ROM of affected joints, which was 7.8 ± 8.1 (mean ± SD) degrees preoperatively,increased to 46.8 ± 18.6 degrees at fi nal follow-up. The fi nal ROM was signifi cantly better in grade I joints, especially when thechildren had operations at ages 24 months or younger. Conclusions: Symphalangism of the hand in children, can be restored into a mobile joint by release of the collateral ligament, adorsal capsulotomy, and postoperative physical therapy.

해방직후 마산지역의 좌우정치세력에 대한 고찰 : 1945년 8월 ~ 12월을 중심으로

백구현 慶熙大學校 大學院 1998 高凰論集 Vol.22 No.-

편측 선천성 근위 요척골 골결합 환자의 전완골 길이 부동

백구현,정진엽,정문상,이충훈,조봉완 대한정형외과학회 2002 대한정형외과학회지 Vol.37 No.6

관절염 수술의 최신 경향 : 수부 수술법 및 효과

백구현 대한근관절건강학회 2002 근관절건강학회지 Vol.9 No.1

[P3-37] 팩틴분해효소를 이용한 신미료 채소의 단세포화물 제조 및 품질평가

백구현,김성수,이영춘 한국식품영양과학회 2005 한국식품영양과학회 학술대회발표집 Vol.2005 No.10

다발성 조갑하 골연골졸 -증례보고-

백구현,김진삼,정문상 대한정형외과학회 2004 대한정형외과학회지 Vol.39 No.6

The osteochondroma is a common benign bone tumor, which is only rarely observed in a subungal location, especially in the fingers. We present a case of multiple subungal osteochondromas, which occurred in the distal phalanges causing nail deformities and pain. 골연골종은 흔한 질환이나 조갑하에 생기는 경우는 드물고 특히 수지의 조갑하에 다발성으로 발생한 경우는 문헌상의 보고가 전무한 실정이다. 저자들은 수지의 원위 지골에 발생하여 조갑 변형과 통증을 일으킨 다발성 조갑하 골연골종을 경험하여 이를 보고하고자 한다.

상완 신경총 손상에서 자연 회복과 신경 재건술간의 비교

백구현,정문상,서중배,박진수,박용범,전득수,Baek, Goo-Hyun,Chung, Moon-Sang,Seo, Joong-Bae,Park, Jin-Soo,Park, Yong-Bum,Jun, Deuk-Soo 대한미세수술학회 1996 Archives of reconstructive microsurgery Vol.5 No.1

서울대학교 의과대학 정형외과학 교실에서는 1985년 1월부터 1994년 12월까지 치험하였던 103명의 환자를 대상으로 최소한 8개월간 보존적 치료를 시행하며 자연 회복을 기다렸고, 수상 후 8개월에서 10개월까지 3개월마다 반복된 근전도 검사상 회복이 없거나 경미한 31명에 대하여 신경 복원술을 시행하여 다음과 같은 결과를 얻었다. 1) 자연 회복은 상완 신경총 손상 환자의 47명(46%)에서 일어났으며, 자연 회복된 환자의 3분의 2(31명)에서 근전도 검사상의 변화가 3개월에서 9개월 사이에 처음 발견되었고, 나머지 3분의 1(16명)의 환자에서 9개월에서 16개월 사이에 발견되어, 평균 7.8개월에 시작됨을 보여주었다. 수정된 AMA score상 내원 당시 14.8점에서 최종 추시 관찰시 39.8점으로 개선되었다. 2) 신경 복원술을 실시한 31명 중 52%가 기능적 호전을 보여주었고 수정된 AMA score상 술전 21.5점에서 술후 36.3점으로 14.8점이 개선되었다. 3) 양군에서 기능적 호전을 보인 비율은 유의한 수준이 아니지만, 기능적 호전의 정도는 25점과 14.8점으로 자연 회복군이 신경 복원술을 실시한 군보다 통계적으로 더 우수한 기능적 호전을 보임을 알 수 있었다(p<0.05). 4) 결국 저자들은 현재까지 손상의 부위와 정도를 정확하게 진단할 수 있는 방법이 부족한 상태에서 이론적으로 많은 문제점을 가지고, 기껏해야 근력 3 내지 4등급의 회복을 위해 환자에게 큰 부담을 주는, 결과가 확실하지도 않은 수술을 하는 것보다 복잡한 해부학적 구조 및 이에 따른 많은 변종을 가진 상완신경총 손상 환자에게 일단 회복이 되면 더 많은 기능 회복을 줄 수 있는 보존적 요법을 시행하며 자연 회복을 기다리는 것이 났다고 생각한다. 그러므로 저자들은 자연 회복이 수상 후 평균 7.8개월에 시작됨으로 자연 회복을 기대하며 1년간 기다려 본 후 1년이 경과하여도 자연회복이 되지 않는 경우에서 수술적 치료를 시행할 것을 제안한다. There has been no general agreement about optimal time for nerve surgery in the closed brachial plexus injury(BPI). From our early experiences, we knew by chance that spontaneous recovery in BPI patients may begin even later than 8 months after injury. Authors' strategy, which was based on our early experiences, for the treatment of closed fresh injury was 'wait and see' unlit 8 months after injury. From 1985 to 1994, we observed 103 patients with BPI. All of them did not have any operation until 8 months after injury. There were 95 men and 8 women with a mean age of 29 years. Motorcycle injury(31%) and vehicle accident(28%) were main causes of injury. Whole plexus types were observed in 56 patients(54%), upper plexus types in 29(28%), lower plexus types in 3(3%), and infraclavicular types in 15(15%). Electromyography was performed in all patients. This was repeated every three months to detect the recovery. Results were evaluated by authors' criteria, in which AMA system of brachial plexus impairment was modified. Duration of follow up was average 25 months. 47 patients(46%) showed spontaneous improvement, which was initially detected at average 7.8 months(range,3 months-16 months) after trauma by electromyography. The average score of these 47 patients improved from 14.8 points to 39.8 points.31 patients(30%) had nerve surgery such as nerve graft, neurotization or neurolysis. Average duration from injury to nerve surgery, was 10 months. Among 31 patients who had nerve surgery, 16 patients improved from preoperative 21.5 points to postoperative 36.3 points in average. Because spontaneous recovery began in average 7.8 months after injury, we think that it would be better to 'wait and see' for at least one year in patients with closed BPI expecting spontaneous recovery.

손목관절 관절경 (Arthroscopy of the Wrist)

백구현 대한관절경학회 2002 대한관절경학회지 Vol.6 No.2