Irreducible Spacer Subluxation after Total Ankle Replacement Arthroplasty in a Patient with Rheumatoid Arthritis: A Case Report

서동교,김상영,Seo, Dong-Kyo,Kim, Sang Young Korean FootAnkle Society 2021 대한족부족관절학회지 Vol.25 No.4

End-stage ankle arthritis is a debilitating condition that causes functional limitations and consequently a poor quality of life. Total ankle replacement arthroplasty is a good alternative to arthrodesis for preserving the ankle's range of motion. However, many complications can occur in patients with rheumatoid arthritis and with poor soft tissue and bone conditions. A 61-year-old female experienced spacer subluxation after surgery, which was not reduced by medial soft tissue release and spacer change. Buttress plating was found to be a good treatment option to prevent spacer subluxation and can be considered in patients with rheumatoid arthritis with bone erosion and soft tissue damage.

Effect of Leg Elevation Height on Reduced Swelling of Patients of Postoperative Acute Ankle Fractures

서동교,강현욱,안득숙,송재석,Seo, Dong-Kyo,Kang, Hyun Wook,Ahn, Deug Suk,Song, Jae-Seok Korean FootAnkle Society 2020 대한족부족관절학회지 Vol.24 No.1

Purpose: Leg elevation is known as an effective method for reducing leg swelling, and it has been routinely used in medical practice. However, the effect of swelling reduction in relation to the degree of elevation height is not known. This study evaluated the swelling of the leg after acute ankle fracture operations at two different elevation heights and the elevated leg heights were compared. Materials and Methods: A total of 66 patients with postoperative acute ankle fractures were classified into two groups depending on the presence of different leg elevation heights: high-elevated (HE, case) and low-elevated groups (LE, control). We checked leg swelling, pain, subjective satisfaction for the elevation device, and the American Orthopedic Foot and Ankle Society (AOFAS) score, and we retrospectively compared them between both the groups. Results: Leg swelling and pain were reduced in both groups. However, they did not show any significant differences between both the groups (p>0.05). Nineteen patients in the HE group replied with uncomfortable, while no patients in LE group did so. The AOFAS score at 1 year postoperatively did not show any significant differences between both the groups (p=0.46). Conclusion: High elevation of the leg after ankle fractures did not show a significant difference from low elevation in regard to leg swelling, pain, and function. Furthermore, high leg elevation resulted in discomfort during the postoperative period. Thus, low elevation with a pillow is enough for acute ankle fracture patients with little discomfort and satisfactory swelling reduction.

당뇨병성 족부 궤양의 치료

서동교,이호승,Seo, Dong-Kyo,Lee, Ho Seong 대한족부족관절학회 2014 대한족부족관절학회지 Vol.18 No.1

In patients with diabetic foot, ulceration and amputation are the most serious consequences and can lead to morbidity and disability. Peripheral arterial sclerosis, peripheral neuropathy, and foot deformities are major causes of foot problems. Foot deformities, following autonomic and motor neuropathy, lead to development of over-pressured focal lesions causing the diabetic foot to be easily injured within the shoe while walking. Wound healing in these patients can be difficult due to impaired phagocytic activity, malnutrition, and ischemia. Correction of deformity or shoe modification to relieve the pressure of over-pressured points is necessary for ulcer management. Application of selective dressings that allow a moist environment following complete debridement of the necrotic tissue is mandatory. In the case of a large soft tissue defect, performance of a wound coverage procedure by either a distant flap operation or a skin graft is necessary. Patients with a Charcot joint should be stabilized and consolidated into a plantigrade foot. The bony prominence of a Charcot foot can be corrected by a bumpectomy in order to prevent ulceration. The most effective management of the diabetic foot is ulcer prevention: controlling blood sugar levels and neuropathic pain, smoking cessation, stretching exercises, frequent examination of the foot, and appropriate education regarding footwear.

당뇨병발의 원인, 진단, 합병증 및 치료

서동교 대한의사협회 2021 대한의사협회지 Vol.64 No.8

Background: Diabetic foot is one of the complications of diabetes mellitus, accompanied by infection, ulcer, deformity, and neuropathic arthropathy. The prevalence of diabetic foot is approximately 10% to 20% in adult diabetic patients over 30 years. Patients with diabetic foot show decreased life quality due to long-term treatment and hospital admission for various complications. Therefore, it is important to understand the etiology of diabetic foot and to prevent the accompanying complications. Current Concepts: Multiple complications of diabetic foot such as ulcers, infections, and deformities are derived from neuropathy (sensory, motor, and autonomic nerves) and angiopathy. Careful physical and radiologic examinations and laboratory evaluations are necessary to diagnose diabetic foot. Dressings, surgical decompressions, antibiotics, and vascular interventions are helpful for the treatment of ulcers in diabetic foot. Maintaining proper blood glucose levels and medication help control the neuropathies. Furthermore, patients should be educated on careful foot care to prevent complications. Discussion and Conclusion: Diabetic foot and its accompanying complications are difficult to treat and decrease patients’ quality of life. To prevent complications of diabetic foot, management of blood glucose, patient education on self-foot care, screening of high-risk factors, and cooperation of various medical specialists are needed.

Novel Nonlinear Optical Photocrosslinking Polymer Systems

서동교,임현순,김환건,이준영 한국고분자학회 2004 한국고분자학회 학술대회 연구논문 초록집 Vol.29 No.2

Synthesis and characterization of novel photoreactive polymer containing cinnamoyl group

임현순,서동교,고정민,성오현,김환건,이준영 한국고분자학회 2004 한국고분자학회 학술대회 연구논문 초록집 Vol.2004 No.04

Synthesis and Characterization of Photoreactive Polymers containing cinnamate groups forphotoalignment

임현순,서동교,고정민,이준영 한국고분자학회 2004 한국고분자학회 학술대회 연구논문 초록집 Vol.29 No.2

아킬레스건 파열 이후의 능동적인 관절 범위 운동이 없는 간단한 재활 운동 방법

황재광,정영주,서동교 대한족부족관절학회 2023 대한족부족관절학회지 Vol.27 No.1

Purpose: Postoperative exercise for acute Achilles tendon rupture is important for a patient’s return to daily life and sports. On the other hand, the protocol requires considerable effort to educate patients and continuous checking. This study evaluated the outcome of a new simple and delayed rehabilitation protocol after Achilles tendon rupture repair. Materials and Methods: From July 2014 to November 2020, one hundred eighty-three patients were operated on by one surgeon. The exercise protocol was classified into two methods. One group (immediate protocol, control group) started immediate full weight bearing with a 20° plantar flexion range of motion from two days postoperatively. Ankle dorsiflexion was restricted to 0°. The other group (delayed protocol, case group) started full weight bearing with a controlled ankle motion boot from two weeks postoperatively. No range of mo- tion exercise was allowed until six weeks postoperatively. Age, sex, body mass index, ankle range of motion, muscle power, time to return to previous physical activity, functional score, and complication rate were evaluated. The results of the two groups were compared using a Mann–Whitney test. Statistical significance was set as p<0.05. Results: The range of motion, double heel rising, and one-leg standing were achieved faster in the control group (p<0.05). However, single-heel rising, repeated single-heel rising, return to previous activity (work, run, and sport), and functional scores showed no statisti- cal difference (p>0.05). Conclusion: Simple and delayed postoperative rehabilitation of acute Achilles tendon rupture without active range of motion exercises showed satisfactory functional results and a low complication rate

대퇴 경부 골절 환자의 치료에서 대퇴 경부 시스템 및 유관 압박 나사 간의 임상 결과 비교

황재광,이기원,서동교,배주열,송명근,최한석 대한골절학회 2023 대한골절학회지 Vol.36 No.3

Purpose: This study compared the clinical and radiological results of the femoral neck system (FNS) and cannulated compression screws (CCS) for the fixation of femoral neck fractures. Materials and Methods: Patients who underwent FNS or CCS internal fixation for femoral neck fractures between January 2016 and January 2022 were analyzed retrospectively. The hip joint function using the Harris hip score (HHS) was evaluated three months and one year after surgery. The operation time, fracture healing time, and associated surgical complications in the two groups were compared and analyzed statistically. Results: Seventy-nine patients were categorized into 38 FNS and 41 CCS groups. The FNS group had a longer operation time and higher postoperative HHS at three months (p<0.01). Femoral neck shortening was lower in the FNS group (p=0.022). There were no significant differences in the fracture healing time and other complications. Conclusion: There were no differences in most clinical outcomes and complications between the two groups except for the three-month HHS and femoral neck shortening. This study suggests that FNS could be an alternative to CCS for treating femoral neck fractures. 목적: 본 연구에서는 CCS 및 FNS를 이용한 대퇴골 경부 골절의 내고정술의 임상적, 방사선학적 결과를 비교하고자 하였다. 대상 및 방법: 2016년 1월부터 2022년 1월까지 본원 정형외과에서 대퇴 경부 골절로 CCS 혹은 FNS를 이용한 내고정술을 시행 받은 환자를 후향적으로 분석하였다. 환자들의 수술 후 3개월, 1년 후 각각의 HHS를 비교하였다. 수술 시간, 수술 후 골절 유합에 걸린 시간 및 합병증을 비교 분석하였다. 결과: CCS군 41명과 FNS군 38명, 총 79명의 환자를 대상으로 하였다. FNS군에서 수술에 소요된 시간이 더 길었으며, 수술 후 3개월에 시행한 HHS가 더 높게 평가되었다(p<0.01). 대퇴 경부 단축은 FNS군에서 유의하게 적었다(p=0.022). 골유합 기간 및 주요 합병증에서는 유의한 차이가 없었다. 결론: 수술 후 3개월 HHS와 대퇴 경부 단축을 제외한 대부분의 임상 결과 및 합병증에서 두 군 간의 차이는 없었다. 대퇴 경부 골절 수술에서 FNS를 이용한 방법은 기존의 CCS를 이용한 수술 방법과 더불어 하나의 선택지가 될 수 있을 것으로 생각된다.

다발성 슬관절 인대 손상과 동반된 총 비골 신경 손상

라호종,이기원,조형권,호병철,서동교,최영준 대한스포츠의학회 2018 대한스포츠의학회지 Vol.36 No.1

Common peroneal nerve (CPN) injury associated with multiple-ligament knee injury is relatively rare. A 38-year-old male presented with left knee pain occurred during ssireum (Korean wrestling). The patient exhibited positive Lachman, grade 3 varus stress, and also positive dial testing at 30o. Sensory loss of some area of left foot and foot drop were observed. Magnetic resonance imaging showed complete anterior cruciate ligament (ACL) rupture and posterolateral corner (PLC) injury. Motor nerve conduction velocity indicated left CPN palsy. ACL and PLC reconstructions were performed 10 days after injury and nerve exploration was done simultaneously. Neurolysis and primary repair were also performed. At 26 months after injury, muscle power of the tibialis anterior and extensor hallucis longus improved to grade 3, and sensation in CPN area recovered to about 60%. There was good stability in injured knee. To the best of our knowledge, this is the first case report describing CPN palsy with multiple-ligament knee injury during ssireum.