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- 저자 : 성열보 ( Yerl Bo Sung ) (검색결과 52 건)
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불안정성 대퇴 전자 주위 골절을 가진 환자에서 항회전 근위 대퇴 골수정을 이용한 치료결과
성열보 ( Yerl Bo Sung ),조성일 ( Sung Il Jo ) 대한고관절학회 2011 Hip and Pelvis Vol.23 No.1
Purpose: This study was performed to review the results of PFNA (Proximal Femoral Nail Antirotation) for treating unstable femoral intertrochanteric fractures. Materials and Methods: Forty-seven out of 187 hips treated from September 2006 to March 2010 with PFNA for unstable femoral pertrochanteric fractures were enrolled in this study. The mean duration to radiologic bone union, the functional status and the complications were assessed. The Cleveland index, the tip apex distance, the sliding distance of the blade and the change in the neck-shaft angle were also measured. Results: The mean duration to radiologic bone union was 15.8 weeks and 66% of the patients recovered to a premorbid functional status. The average amount of blade sliding was 5.5 mm and the mean change of the neck-shaft angle was varus 4.4˚. There were 2 cases of penetration of the blade tip, 2 cases of impending penetration, one case of posttraumatic osteonecrosis of the femoral head and 2 cases of lateral wall fractures. Conclusion: PFNA would be preferable for unstable femoral intertrochanteric fractures in terms of the short operation time, the rapid ambulatory recovery and the reduced complications. Yet careful handling is required to avoid a grave complication such as head penetration.
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Bisphosphonate 복용과 연관된 대퇴골 비전형 골절
성열보 ( Yerl Bo Sung ),최정윤 ( Jung Yun Choi ),엄규섭 ( Kyu Sub Um ) 대한고관절학회 2013 Hip and Pelvis Vol.25 No.1
목적: 대퇴골 전자하부 및 간부 골절 환자들을 후향적으로 분석하여 bisphosphonate 복용군과 비복용군간의 비전형 대퇴 골절의 빈도, 임상적 및 방사선적 특징의 차이를 알아보고자 하였다. 대상 및 방법: 2001년 8월부터 2011년 10월까지 저에너지 대퇴골 전자하부 및 골간부 골절로 수술한 60세 이상 여자 환자 41명, 44예를 대상으로 bisphophonate를 복용 한 A군(19명, 22예)과 복용 안한 B군(22명, 22예)으로 나누었다. 복용 기간, 전구증상 유무, 방사선 소견을 조사하고, 나이, 골밀도 검사, 골유합 기간, 불유합 유무를 비교 분석하였다. 결과: A군에서 평균 복용 기간 56.8개월(12-132개월), 전구증상 1예, 모두 외측 피질골 비후, 횡적 골절, 내측 피질골 돌출이 관찰되었고, 반대측 피질골 비후 소견 15명(17예)(77.3%)이었다. 나이는 A군 73.2세, B군 78.2세로 유의한 차이를 보였다(P=0.021). 골밀도, 골유합 기간, 불유합 유무는 통계적 유의한 차이가 없었다. 결론: 대퇴골 비정형 골절은 외측 피질골 비후, 내측 피질골 돌출, 횡적 골절의 특징적 소견을 보이며 반대측 피질골 이상 소견을 동반한다. bisphosphonate를 장기복용 중인 골다공증 환자는 비전형 골절에 주의를 기울여야 한다. Purpose: We attempted to determine the differences in frequency, as well as clinical, radiologic characteristics of atypical femoral fracture between groups of patients who have taken bisphosphonate and those who have not by conduct of a retrospective analysis of patients with low energy subtrochanteric and shaft fractures of the femur. Materials and Methods: We conducted a retrospective study of 44 cases of 41 female patients over 60 years old who underwent surgery due to femoral shaft/subtrochanteric fractures from August 2001 to October 2011. The patients were divided into two groups: Group A, 22 cases in 19 patients with a history of bisphosphonate treatment; Group B, 22 cases in 22 patients without a history of bisphosphonate treatment as a control group. We assessed the duration of bisphosphonate treatment, presence of prodromal symptoms, and radiological results, and compared age, BMD results, union period, and nonunion rate between the two groups. Results: Mean medication period was 56.8 months(12-132 months) and prodromal symptoms were observed in one case. Lateral cortical thickening and transverse fracture with a medial cortical bone beak were observed in all patients of Group A, and contralateral cortical hypertrophy of the femur was noted in 15 patients(17 cases) (77.3%). Mean age was 73.2 years in Group A and 78.2 years in Group B, which showed significant difference (P=0.021), while no difference was observed in BMD, union period, and nonunion rate. Conclusion: An atypical femoral fracture can occur in the subtrochanteric or shaft of the femur. The typical radiological characteristics of this fracture are lateral cortical thickening and transverse fracture with a medial cortical bone beak and contralateral abnormality of cortical bone. Findings of this study suggest that medical practitioners should be careful of atypical fractures with osteoporosis patients who use prolonged bisphosphonate.
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대퇴 주대 보존 후 관절 내 항생제 혼합 시멘트 충전물을 이용한 인공 고관절 감염에 대한 단계적 재치환술
성열보 ( Yerl Bo Sung ),오종석 ( Jong Seok Oh ) 대한고관절학회 2010 Hip and Pelvis Vol.22 No.1
Purpose: When the femoral stem was well fixed in patients with a deep prosthetic hip infection, the authors performed a two-stage revision procedure using antibiotic-loaded cement spacers (ALCS) without removal of the stem, and the efficacy of this treatment was assessed. Materials and Methods: For 12 cases of infected hip arthroplasties, a two-stage procedure was performed, and the patients were followed up for over 2 years. After the acetabular component and head was removed, debridement was done. The molded ALCS was inserted. Revision was then performed after eradication of the infection. The results were analyzed, including the changes in the clinical manifestation, the radiologic findings, the laboratory results, the functional score and the complications. Results: Of all 12 cases, the two-stage revision arthroplasty using an ALCS with retention of the stem was performed in 11 cases (92%), on an average of 66 days (range: 40~152 days). In the 11 revised cases, there was no evidence of recurrence of infection. In the 11 cases, the mean Harris hip score improved from 40.1 points preoperatively to 91.8 points at last the follow-up. The mean WOMAC score improved from 41.8 points preoperatively to 81 points at the last follow-up. The mean Harris hip score was 85.3 points and the WOMAC score was 72.4 points during the ALCS insertion-period. Conclusion: For the case of a perioprosthetic hip infection with a well-fixed femoral stem, two-staged revision using an ALCS without stem removal could be an alternative method in terms of effective infection control and preservation of the joint function.
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Collarless Polished Tapered 대퇴 주대를 이용한 인공고관절 치환술 -최소 2년 이상 추시 결과-
성열보 ( Yerl Bo Sung ),최정윤 ( Jung Yun Choi ),오수찬 ( Su Chan Oh ) 대한고관절학회 2012 Hip and Pelvis Vol.24 No.1
목적: CPT 대퇴 주대를 이용한 인공 고관절 전치환술 및 양극성 고관절 반치환술의 최소 2년 이상 임상적 결과와 방사선학적 결과에 대해 알아보고자 하였다. 대상 및 방법: 2006년 10월부터 2009년 4월까지 CPT 대퇴 주대를 이용하여 인공 고관절 치환술을 시행한 환자 중 2년 이상 추시 관찰한 33예를 대상으로 하였다. 33명의 환자 중 남자는 6명, 여자는 27명이었으며 수술 시 평균 연령은 74세였다. 평균 추시 기간은 33개월(24-48개월)이었고 임상적 결과는 HHS을 이용하여 평가하였고 방사선학적 평가에 있어서는 시멘트 등급과 대퇴 주대 수직 침강 및 근위 대퇴골 골 흡수를 평가하였다. 결과: 임상적인 평가에서 HHS는 수술 전 평균 55점에서 수술 후 평균 91점으로 향상 되었으며 방사선학적 평가에서 시멘트 등급은 A등급은 14예, B등급은 14예, C1등급은 5예였다. 근위 대퇴골 골 흡수 평가에서 1등급은 22예, 2등급은 1예였다. 수직 침강 소견은 평균 0.51 mm로 전예에서 의미 있는 수직 침강 소견은 보이지 않았다. 이소성 골화 현상은 총 13예에서 관찰되었다. 결론: CPT 대퇴 주대는 2년 이상 추시에서 임상적인 결과 및 방사선학적 평가에서 만족스러운 결과를 보였다. 하지만 좀 더 정확한 결과를 위해 장기간의 추시가 필요할 것으로 사료된다. Purpose: This study evaluated the clinical and radiologic results of total hip arthroplasty and bipolar hemiarthroplasty using collarless polished tapered femoral stem. Materials and Methods: We retrospectively reviewed the results of 33 patients who underwent THA and BHA using cemented CPT femoral stem from November 2006 to April 2009. The mean follow-up period was 33 months. The clinical results were evaluated with a Harris Hip Score (HSS), and radiographic results were assessed with cement grade, osteolysis, loosening, stress shielding and subsidence methods, Results: Mean HSS improved with 91 points, Postoperative cement grade was A in 14 cases, B in 14 cases, C1 in 5 cases and D in none. Aseptic loosening was not found, while focal radiolucency in zone 8 was found. 70% of stems showed grade 1 and 2 stress shielding according to Engh`s criteria. Subsidence of the femoral stem was less than 1 mm in 32 cases, and was 1.47 mm in another case. Ectopic ossification was observed in 13 cases, class I in 11 cases, and class II in 2 cases, using Brooker`s classification. Conclusion: This study showed the good clinical and radiographic results of THA and BHA with a cemented CPT femoral stem at the mid-term follow-up. However, a long-term follow-up study will be needed to evaluate the more precise clinical and radiographic outcomes.
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