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박종범,이화성,이승구,정진화,엄의용,황희주 대한골절학회 2001 대한골절학회지 Vol.14 No.4
Purpose: To find the proper way and timing of treatment for minimizing the post-traumatic complication of peritalar dislocation or fracture-dislocation. Material and Methods: We reviewed total 12 cases of peritalar dislocation or fracture-dislocation that consist of 9 cases of subtalar joint dislocations, 1 case of talo-navicular joint dislocation and 2 cases of talar fracture-dislocations. Closed reduction was performed for subtalar dislocation without suturing the torn ligaments. The average follow up period was 25 months. Results: Of 9 subtalar dislocations, 8 cases presented acceptable results. But 1 case of a 28-year-old male patient with prolonged heavy sports activity history presented pain and mild limping. The other 3 cases of talo-navicular joint dislocation and talar fracture-dislocations presented acceptable results except one complaining of scar contracture. Conclusion: Complications such as early skin necrosis or neurovascular damage could be prevented by early closed reduction for peritalar dislocations or fracture-dislocations, and the repair of torn ligaments of ankle joint in peritalar dislocations did not affect the end results.
장관골 골절 지연유합의 치료에 이용한 자가 골수이식술의 결과
김진영,한창환,성진형,김원유,류재덕,엄의용 대한골절학회 1999 대한골절학회지 Vol.12 No.4
For resolving problems of delayed union and non-union of long bones, many efforts was made such as autogenous graft, allogenic or artificial bone graft and electrical stimulation, but there were many complications and not sufficient fracture healing process. The purpose of this study was to investigate the effect of autograft with bone marrow on the repair or bone formation of delayed union by the serial radiogram and clinical examination. We evaluated thiry nine patients which had been treated for long bone fracture, to whom bone marrow injection was made between 3 months and 13 months after adequate fixation(average 4.8months). After bone marrow injection, clinical follow up period was from 15 months to 36 months(average 26.7 months). The age distribution was from 18 years to 84 years(average 42). A total of 100-150cc of marrow was injected at the nonunion site immediately after aspiration under the C-arm. Of 39 cases, there were improved bone healing process of 30 cases(77%) by radiographically and clinically. Of 9 cases without improvement, 5 cases were due to loosening of external fixator, 2 cases was due to chronic osteomyelitis and other 2 cases was unknown origin. No serious complications were observed other than no improvement. Although percutaneous bone marrow injection does not promote healing more rapidly than would standard operative bone grafting, it has many distinct advantages over the latter. It is safe, easy, and time saving. It is economical and involves minimal trauma. It can be done under local anesthesia and avoids the risks of general anesthesia, infection and surgery. It can be done in cases which are not fit for open bone grafting because of poor condition of the skin.