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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.
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족관절 골관절염에서의 관절 내 Hyaluronic Acid 주사의 유용성
박철현,박정진,석현규,우인하 대한족부족관절학회 2022 대한족부족관절학회지 Vol.26 No.2
Purpose: This study sought to investigate the appropriate indications for intra-articular injection of hyaluronic acid in ankle osteoarthritis, its efficacy at each stage of osteoarthritis and to compare the efficacy related differences at each stage. Materials and Methods: A retrospective study was conducted from January 2016 to September 2019 on 43 patients (50 cases) diagnosed with ankle arthritis and given intra-articular injection of hyaluronic acid. Patients were classified according to the modified Takakura ankle osteoarthritis stages. Stage 2 comprised 24 cases; stage 3A, 15 cases; stage 3B, 8 cases; and stage 4, 3 cases. The clinical evaluation was carried out using the visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, and the Foot and Ankle Outcome Score (FAOS). The patients’ satisfaction with the injection was evaluated at 1 year after injection. A radiographic evaluation was performed to gauge the progression of osteoarthritis before and after the injection. Results: The VAS, AOFAS score, and FAOS at 3 months and 1 year after injection showed statistically significant improvements compared to those before the injection. There was a significant difference in the VAS for each stage over time; however, this was not the case with the AOFAS score and the FAOS. A significant improvement of the VAS after injection was seen only in stage 3A when compared with the other stages. The overall satisfaction rate with the injection was 90%. There were no ankle osteoarthritic stage changes in the serial follow-up radiograph. Conclusion: Intra-articular injection of hyaluronic acid resulted in a significant clinical improvement up to 1 year after the injection. Therefore, the intra-articular injection of hyaluronic acid could be a treatment option for ankle osteoarthritis.
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