Extensive Bullous Complication Associated with Intermittent Pneumatic Compression

원성훈,이영균,서유성,구경회 연세대학교의과대학 2013 Yonsei medical journal Vol.54 No.3

Intermittent pneumatic compression (IPC) device is an effective method to prevent deep vein thrombosis. This method has been known to be safe with very low rate of complications compared to medical thromboprophylaxis. Therefore, this modality has been used widely in patients who underwent a hip fracture surgery. We report a patient who developed extensive bullae, a potentially serious skin complication, beneath the leg sleeves during the use of IPC device after hip fracture surgery.

짧은 아킬레스건의 의미

원성훈,천동일,Won, Sung Hun,Chun, Dong-Il 대한족부족관절학회 2021 대한족부족관절학회지 Vol.25 No.2

This review article attempts to describe several pathological conditions that can arise from the shortening of the Achilles tendon. The tension and tightening of the gastrocnemius-soleus-Achilles tendon complex (GSAC) can cause disharmony in the movement of the entire foot as well as the ankle joint when subjected to weight-bearing or walking. In addition, since these phenomena are observed in various lesions of the ankle joint, the dynamic shortening caused by the tension of GSAC may not be the primary cause of various ankle joint lesions, but is still considered to be a significant contributing factor.

Buddy Taping: Is It a Safe Method for Treatment of Finger and Toe Injuries?

원성훈,이상림,정진엽,이경민,성기혁,김태균,최영,이상형,권대규,하재홍,이승열,박문석 대한정형외과학회 2014 Clinics in Orthopedic Surgery Vol.6 No.1

Background: Buddy taping is a well known and useful method for treating sprains, dislocations, and other injuries of the fingers or toes. However, the authors have often seen complications associated with buddy taping such as necrosis of the skin, infections, loss of fixation, and limited joint motion. To our knowledge, there are no studies regarding the complications of buddy taping. The purpose of this study was to report the current consensus on treating finger and toe injuries and complications of buddy taping by using a specifically designed questionnaire. Methods: A questionnaire was designed for this study, which was regarding whether the subjects were prescribed buddy taping to treat finger and toe injuries, reasons for not using it, in what step of injury treatment it was use, indications, complications, kinds of tape for fixation, and special methods for preventing skin injury. Fifty-five surgeons agreed to participate in the study and the survey was performed in a direct interview manner at the annual meetings of the Korean Pediatric Orthopedic Association and Korean Society for Surgery of the Hand, in 2012. Results: Forty-eight surgeons (87%) used buddy taping to treat finger and toe injuries, especially proximal interphalangeal (PIP) injuries of the hand, finger fractures, toe fractures, metacarpophalangeal injuries of the hand, and PIP injuries of the foot. Sixty-five percent of the surgeons experienced low compliance. Forty-five percent of the surgeons observed skin injuries on the adhesive area of the tape, and skin injuries between the injured finger and healthy finger were observed by 45% of the surgeons. Conclusions: This study sheds light on the current consensus and complications of buddy taping among physicians. Low compliance and skin injury should be considered when the clinician treats finger and toe injuries by using buddy taping.

21대 총선 여론조사, 실제 표심 잘 반영했다

원성훈 관훈클럽 2020 관훈저널 Vol.- No.155

Outcome Differences of Remnant-Preserving versus Non-Preserving Methods in Arthroscopic Anterior Cruciate Ligament Reconstruction: A Meta-analysis with Subgroup analysis

원성훈,Byung-Il Lee,Su Yeon Park,Kyung-Dae Min,김준범,권세원,김용범,서기원,Jae-Hyung Kim,최형석 대한슬관절학회 2020 대한슬관절학회지 Vol.32 No.-

Purpose: To analyze differences in clinical outcomes of arthroscopic anterior cruciate ligament reconstruction between remnant-preserving and non-preserving methods. Methods: International electronical databases PubMed, Embase, and the Cochrane central database from January 1966 to December 2017 were searched for randomized controlled trials (RCTs) and observational studies that compared differences of clinical outcomes of ACL reconstruction with and without remnant preservation. A metaanalysis of these studies was performed to compare clinical outcomes. Subgroup analyses were conducted to evaluate the role of methodological quality in primary meta-analysis estimates. Results: Five RCTs and six observational studies were included in this meta-analysis and subgroup analysis. The remnant-preserving method in arthroscopic ACL reconstruction showed a statistically significant difference compared to the non-preserving method regarding arthrometric evaluation (side-to-side difference). Lachman test, Lysholm scores, and IKDC subjective scores showed statistically minor difference in meta-analysis, but showed no significant difference in subgroup analysis. Remained parameters including pivot shift test, IKDC grades, incidence of cyclops lesion showed no statistically differences in meta-analysis or subgroup analysis. Conclusions: This meta-analysis with subgroup analysis showed that arthroscopic remnant-preserving ACL reconstruction provided statistically significant but limited clinical relevance in terms of arthrometric evaluation. Results of Lachman test, Lysholm scores, and IKDC subjective scores demonstrated statistically minor differences.

Risk Factors Associated with Amputation-Free Survival in Patient with Diabetic Foot Ulcers

원성훈,이경민,정진엽,박문석,이태승,성기혁,이승열,김태균 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.5

Purpose: To determine the 1-year survival rate, 1-year amputation-free survival rate and the risk factors of amputation for patients with diabetic foot ulcers. Materialsand Methods: One hundred seventy-three patients with diabetic foot ulcers were included in our study. Mean patient age was 67.5 (range, 29 to 87, SD ±11.4) years. 74% of the patients were male. Time from study entry to amputation and time to death were evaluated separately as censored event times by Kaplan-Meier curves and log-rank tests. A multivariate Cox proportional hazards regression analysiswas carried out for determining the risk factors of amputation. Results: The survival rate and amputation-free survival rate were 96.5% (n=167), 65.9% (n=114), respectively, over one year study period. Severity of ulcer was the strongestsignificant risk factor of amputation [hazard ratio (HR): 7.99; confidence interval(CI): 3.12 to 20.47]. Peripheral artery disease was also independent risk factor of amputation (HR: 2.64; CI: 1.52 to 4.59). Conclusion: In assessing the prognosis of diabetic foot ulcers, clinicians should consider the severity of ulcer and presence of peripheral artery disease. Our study provides important insights into clinical practice and supplementary information for both physicians and patients.

일교차가 당뇨병성 창상의 치유에 미치는 영향: 동물 실험 연구

원성훈,천동일,조재호,박인근,이영,Won, Sung Hun,Chun, Dong-Il,Cho, Jaeho,Park, In Keun,Yi, Young 대한족부족관절학회 2020 대한족부족관절학회지 Vol.24 No.4

Purpose: Diabetic foot ulcers are closely related to body surface heat, which can be affected easily by temperature differences. This study examined the correlation between the healing process of diabetic wounds and abnormal diurnal temperature through an animal study. Materials and Methods: Rats in the abnormal diurnal temperature group and control group were given a 10 mm sized full-thickness skin ulcer. Wound size progression was observed in both groups. H&E and Masson's trichrome staining was performed at 14 days after wound formation, and the number of vessels per unit area and histology analysis were performed. The changes in the ulcer were measured through three dimensional cross-section area using INSIGHT^® devices. Results: The wound recovery period (granulation ingrowing) was 24 days in the abnormal diurnal temperature model and 20 days in the control group. The thickness of scar tissue was 402±23.19 ㎛ in the control group and 424.5±36.94 ㎛ in the diurnal temperature model. Neovascular formation was counted as 5.1±0.97 for the control group and 4.16±0.94 for the diurnal temperature model group. Conclusion: Delayed and inferior diabetic wound healing was observed in the abnormal diurnal temperature group, which was characterized by greater diurnal variations than the typical growth environment.

스포츠 손상에 의한 아킬레스건의 급성 분절 파열: 증례 보고

천동일,원성훈,이상현,조재호,Chun, Dong-Il,Won, Sung Hun,Lee, Sang Hyeon,Cho, Jaeho 대한족부족관절학회 2017 대한족부족관절학회지 Vol.21 No.2

Tendoachilles rupture has recently seen an increase in frequency, accounting for up to 40% of all tendon ruptures. However, an acute segmental rupture of the Achilles tendon is very rare with only one case caused by predisposing factors, such as steroid injection. In this report, we highlight an unusual clinical presentation of a segmental rupture of the Achilles tendon without any underling predisposing factor and without direct trauma. Herein, we discuss its mechanism. Twelve months after surgical repair with open technique, this patient became fully functional again in daily activity.

당뇨병 합병증으로 인한 하지 절단율의 지역적 변이 및 지역 특성 요인과의 관계 분석

조재호,원성훈,김재형,천동일,이영,박수연,정광영,박근현 대한족부족관절학회 2019 대한족부족관절학회지 Vol.23 No.3

Purpose: To investigate the spatial distribution of diabetes-related lower limb amputations and analyze the relationship between the spatial distribution of diabetes-related lower limb amputations and regional factors. Materials and Methods: This study was performed based on the data from the Korean Health Insurance Review and Assessment Service, in 2016. The unit of analysis was the administrative districts of city·gun·gu. The dependent variable was the age- and sex-adjusted incidence of diabetes-related lower limb amputations and the regional variables were selected to represent two aspects: socioeconomic factors, and health and medical factors. Along with traditional ordinary least square (OLS) regression analysis, geographically weighted regression (GWR) was applied for spatial analysis. Results: The age- and sex-adjusted incidence of diabetes-related lower limb amputation varied according to region. OLS regression showed that the incidence of diabetes-related lower limb amputation had significant relationships with the health and medical factors (number of healthcare institution and doctors per 100,000 population). In GWR, the effects of regional factors were not consistent. Conclusion: The spatial distribution of the incidence of diabetes-related lower limb amputations and the effects of regional factors varied according to the regions. The regional characteristics should be considered when establishing health policy related to diabetic foot care.

Survivorship and Complications after Hip Fracture Surgery in Patients with Chronic Kidney Disease

서유성,원성훈,최형석,이재철,천동일,노재휘,이환웅,김진형 대한의학회 2017 Journal of Korean medical science Vol.32 No.12

The aim of this study was to investigate survival rate, complications and associated risk factors after hip fracture surgery in patients with chronic kidney disease (CKD) by comparing to non-CKD patients. A total of 119 patients (130 hips, 63 hips CKD group, 67 hips non-CKD) who underwent hip fracture surgery were included. We assessed variables including age, gender, CKD, comorbidities, operation delay and operation time as risk factors for survival and complications after hip fracture surgery. The survival rate was 55.8% at 1-year, 45.8% at 3-year, and 31.4% at 5-year in CKD group, whereas 82.1%, 60.7%, and 36.8%, respectively in non-CKD. Age (more than 85) (hazard ratio [HR], 3.238; 95% confidence interval [CI], 1.736–6.042; P < 0.001), stages 4, 5 of CKD (HR, 2.004; 95% CI, 1.170–3.433; P = 0.001), cerebrovascular disease (HR, 2.213; 95% CI, 1.196–4.095; P = 0.001), and malignancy (HR, 3.086; 95% CI, 1.553–6.129; P = 0.001) were significant risk factors. Complications occurred in 17 hips of CKD group and 8 hips of non-CKD. Stage 4–5 of CKD (odds ratio [OR], 3.401; 95% CI, 1.354–8.540; P = 0.001), malignancy (OR, 3.184; 95% CI, 0.984–10.301; P = 0.050) were significant risk factor. When performing hip fracture surgery in patients with CKD, surgeons should consider age, severity of CKD, and presence of other comorbid disease, such as cerebrovascular disease and malignancy, as patients with these risk factors will need more intensive preoperative and postoperative care.