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심재익 ( Jae Ik Shim ),김택선 ( Taik Seon Kim ),이성종 ( Sung Jong Lee ),이석하 ( Suk Ha Lee ),김영배 ( Young Bae Kim ),윤정로 ( Jong Ro Yoon ),설의상 ( Eui Sang Seol ),박광열 ( Kwang Yeol Park ),강대웅 ( Dae Woong Kang ) 대한골절학회 2001 대한골절학회지 Vol.14 No.3
목적: 대퇴골 간부 골절치료 후 발생한 불유합의 수술적 치료 결과를 임상적 및 방사선학적으로 분석하고자 하였다. 대상 및 방법: 1993년 1월부터 1999년 12월까지 대퇴골 간부 불유합으로 수술한 환자 21예를 대상으로 하였으며 추시 기간은 평균 15개월이었다. 초기 골절의 원인, 형태와 분류 및 불유합의 원인을 임상적 및 방사선학적으로 분석하였다. 불유합의 수술 방법으로 자가골 이식술과 교합성 골수강내 금속정을 이용한 견고한 내고정술을 시행하였으며 골유합의 기간과 결과를 분석하였다. 결과: 평균 골유합 기간은 22주이었으며 21예중 18예(85.7%)에서 골유합 소견을 보였고 합병증으로는 하지 단축과 파행이 2예, 관절 부분 강직이 2예, 천부 감염이 2예이었다. 결론: 대퇴골 간부 불유합의 치료시 그 원인과 형태에 따라 자가골 이식술과 교합성 골수강내 금속정을 이용한 견고한 내고정술로 양호한 결과를 얻을 수 있을 것으로 생각되었다. Purpose: The purpose of this study is to analyze the clinical and radiological result of surgical treatment for femoral shaft nonunion. Materials and methods: From January 1993 to December 1999, 21 cases of femoral shaft nonunion were treated surgically and followed for an average of 15 months. We analyzed initial cause of injuries, classification of fractures, and cause of nonunion in clinically and radiologically. The authors analyzed the average time to union and results after surgical treatment by rigid internal fixation with interlocking intramedullary nail and autogenous bone graft. Results: The mean duration of bony union was 22 weeks and bony union achieved in 18 cases(85.7%) of 21 cases. The complications were shortening of leg length and limping gait in 2 cases, partial limitation of knee joint in 2 cases, superficial infection in 2 cases. Conclusion: Rigid internal fixation with interlocking intrameduallary nail and bone graft is useful method of treatment for femoral shaft nonunion according to cause and type of nonunion.
변형된 비구를 가진 환자에서 Interface Bioactive Bone Cement 기법과 대퇴골두 자가골 이식술을 이용한 고관절 전치환술
심재익 ( Jae Ik Shim ),김택선 ( Taik Seon Kim ),이성종 ( Sung Jong Lee ),이석하 ( Suk Ha Lee ),신재준 ( Jae Joon Shin ) 대한고관절학회 1998 Hip and Pelvis Vol.10 No.1
Distorted acetabulum with secondary degenerative changes can result in a high riding subluxated laterally or dislocated femoral head. In these cases, the results of conventional methods total hip arthroplasty(THA) resulted as unsatisfactory. Seating the acetabular component in the false acetabulum creates a compromise of available bone stock and biomechanical considerations, including a lateral, more proximal hip joint fulcrum and shortening of the abductor muscles. The use of a femoral head autograft in acetabular reconstruction is an effective method to treat acetabular distortion. In order to solve the bone interface problems of traditional PMMA bone cement, we studied interface bioactive bone cement technique(IBBC). Eighteen cases were treated with total hip arthroplasty using femoral head autograft and interface bioactive bone cement for the distorted acetabulum from December, 1991 to June, 1995 and followed up during average 36 months at Korea Veterans Hospital(range: 24 months to 54 months). Ten cases with acetabular defect below 25% were treated by interface bioactive bone cement and morselized bone graft with PE(polyethylene) cup and eight cases with acetabular defect above 25% were treated by interface bioactive bone cement and structural bone graft with PE eup. The mean Harris hip scores was improved from 59 preoperatively to 89 postoperatively. Furthermore, successful clinical results were obtained in most of our presented series with improved fascinating interface problems.
윤정로,심재익,김택선,이성종,김영배,김학준,이태진,고대철,Yoon, Jung-Ro,Shim, Jae-Ik,Kim, Taek-Seon,Lee, Sung-Jong,Kim, Young-Bae,Kim, Hak-Joon,Lee, Tae-Jin,Ko, Dae-Chul 대한근골격종양학회 2002 대한골관절종양학회지 Vol.8 No.3
말초신경초 내에 발생하는 결절종은 일부 보고된 바는 있으나, 발생빈도는 드문 것으로 되어있으며, 발생 부위는 슬관절과 근위 경비관절 부위의 비골신경에서 가장 흔한 것으로 보고 되어 있다. 저자들은 신경학적 증상없이 슬관절부 비골신경 내에 발생한 결절종에 대하여 후유증 없이 치료하여 이를 보고하고자 한다. Ganglion cysts occurring within sheaths of peripheral nerves have been documented, but are relatively rare entities. The peroneal nerve at the level of the knee and proximal tibiofibular joint is most commonly involved. We report a case of the intraneural ganglion cyst in the peroneal nerve without neurologic deficit, which was excised sucessfully.