요추간판탈출증에 대한 신전운동요법의 효과

김홍태(Hong-Tae Kim),유찬훈(Chan-Hoon Yoo),장세앙(Se-Ang Chang),최인학(In-Hak Choi),이근일(Keun-Il Lee) 대한정형외과학회 1997 대한정형외과학회지 Vol.32 No.7

퇴행성 요추전방전위증의 수술적 치료에 대한 고찰

김홍태(Hong Tae Kim),박봉훈(Bong Hoon Park),변영수(Young Soo Byun),강도원(Doh Won Kang),유찬훈(Chan Hoon Yoo) 대한정형외과학회 1991 대한정형외과학회지 Vol.26 No.3

요추간판의 원측방 탈출증에 대한 임상적 고찰

김홍태(Hong Tae Kim),박봉훈(Bong Hoon Park),변영수(Young Soo Byun),유찬훈(Chan Hoon Yoo),강도원(Doh Won Kang) 대한정형외과학회 1991 대한정형외과학회지 Vol.26 No.5

압박 고 나사로 치료한 대퇴골 전자부 골절 : 고정 실패의 인자에 대한 분석 Analysis of Factors associated with Failure of Fixation

유찬훈,김홍태,변영수,남준모,조영호,문성건 대한골절학회 2002 대한골절학회지 Vol.15 No.4

목 적 : 압박 고 나사로 치료한 대퇴골 전자부 골절의 고정 실패에 영향을 미치는 요소에 대하여 분석하고자 하였다. 대상 및 방법 : 1995년 5월부터 2000년 7월까지 대퇴골 전자부 골절을 압박 고 나사를 이용하여 치료하고 1년 이상 추시가 가능했던 97예를 대상으로 하였다. 골절의 분류는 Jensen 분류법을, 골다공증의 정도는 Singh 지수를 이용하였다. 술후 방사선 검사에서 경체각, 정복 상태, 지연 나사의 대퇴골 두 내 위치, tip-apex distance(TAD) 및 지연 나사의 활강 거리를 측정하였고 고정 실패에 미치는 영향을 통계학적으로 분석하였다. 결 과 : 97예 중 17예(17%)에서 고정 실패가 발생하였고 그 중 지연 나사의 과도한 활강으로인한 경우가 15례(15.4%), 골두 천공 1얘, 10도 이상의 외반 변형 1예였다. 고정 실패의 발생과 80세 이상의 고령, 불안정성 골절, telescoping 정복, 원위 골편의 내측 혹은 전방 전위, 대퇴골 두 내 지연 나사의 위치와 밀접한 관계가 있었다. 결 론 : 압박 고 나사를 이용한 대퇴골 전자부 골절의 치료에서 고정 실패를 방지하기 위해서는 정확한 정복이 필요하고 대퇴골 두 내에서 지연 나사의 전방 위치를 피하는 것이 좋을 것으로 사료된다. Purpose : This study was performed to analyze the significant factors that may affect failure of fixation in trochanteric fractures of the femur treated with the compression hip screw. Materials and Methods : From May 1995 to July 2000, the authors analyzed 97 cases of trochanteric fracture of the femur treated with the compression hip screw and followed more than one year. We classified the fracture type by Jensen's method. We used Singh index for the degree of osteroporosis. In the post-operative radiograph, we checked neck-shaft angle, state of reduction, position of the lag screw within the femoral head, tip-apex distance, and sliding distance of the lag screw. The relationship between these factors and failure of fixation was statistically analyzed. Results : There were 17 cases(17.5%) of failure of fixation ; 15 cases(15.4%) of excessive sliding of the lag screw, 1 case (1%) of cutting out of the lag screw, and 1 case (1%) of valgus malunion. There were significant relationship between failure of fixation and old age over 80 , unstable fracture, telescoping reduction, anterior or medial displacement of the distal fragment, and anterior placement of the lag screw within the femoral head. Conclusion : Accurate reduction and avoidance of the placement of the lag screw in the anterior part of the femoral head were important factors to prevent failure of fixation in trochanteric fractures of the femur treated with the compression hip screw.

쇄골 간부 골절 불유합의 수술적 치료 : 재건 금속판 고정 및 골 이식술 Reconstruction Plate Fixation and Bone Grafting

변영수,유찬훈,안혁수,문성건,신동주,박준우 대한골절학회 2003 대한골절학회지 Vol.16 No.2

목 적: 쇄골 간부 골절 불유합에 대하여 관혈적 정복, 재건 금속판 고정 및 골 이식을 시행하고 술후 조기 관절 운동을 허용한 저자들의 경험을 보고하는 것이다. 대상 및 방법: 1997년 1월부터 2001년 12월까지 수술적 치료를 시행한 쇄골 간부 골절 불유합 16예를 대상으로 하였다. 위축성 불유합이 10예, 비후성 불유합이 6예였으며, 수상 후 불유합에 대한 수술까지의 기간은 평균 6.5개월이었다. 수술적 치료로 불유합 부위를 노출시켜 섬유조직을 제거하고 골수강을 천공하였으며, 골편을 정복하고 재건 금속판으로 고정하였으며, 자가 골 이식을 하였다. 수술 후 관절 운동은 1주일 이내에 시작하였다. 결 과: 평균 추시 기간은 22.0개월이었으며, 전 예에서 평균 10.0주에 골유합을 얻었다. 최종 추시 시의 견관절 운동범위는 전 예에서 정상으로 회복되었으며, 나이가 50게 이상인 6예 중 3예에서 동측 견관절에 간헐적인 동통을 호소하였다. 술후 감염, 재검 금속판의 파손, 고정상실, 불유합, 재골절 등의 합병증은 발생치 않았다. 결 론: 쇄골 간부 골절 불유합에 대한 관혈적 정복, 재건 금속판 고정 및 골 이식은 안정성 고정으로 조기 재활이 가능하고 견고한 골유합을 얻을 수 있어 안전하고 확실한 치료방법으로 사료된다. Purpose: The purpose of this study is to present out experience with open reduction, 3.5-㎜ reconstruction plate fixation, bone-grafting, and postoperative early mobilization for nonunions of midshaft clavicular fratures. Materials and Methods: Sixteen patients were treated operatively for nonunions of the midshaft of the clavicle from 1997 to 2001. Ten nonunions were atrophic and six were hypertrophic. Nonunion had been present for an average of 6.5 months. The operative technique included removing the fibrous tissue from the nonunion site and opening the medullary canal, reduction of the fracture and fixation with a 3.5-㎜ reconstruction plate, and bone-grafting. Postoperative mobilization started within one week. Results: The average duration of follow-up was 22.0 months. All fracture were united in an average of 10.0 weeks. All patients had full range of motion of the ipsilateral shoulder, but 3 our of 6 patients who were more than 50 years old complained occasional pain in the ipsilateral shoulder at the final follow-up examination. There were no major complications of postoperative infection, metal failure of the plate, loss of fixation, nonunion, and refracture after removal of the implant. Conclusion: The technique of open reduction, reconstruction plate fixation, and bone-grafting is a safe and reliable method to allow early rehabilitation by stable fixation and to predict a high rate of union for nonunions of midshaft clavicular fractures.

요추부 유합수술 후 가동인접분절의 후기변화

김홍태,강도원,유찬훈,정재호,장세앙 대한척추외과학회 1996 대한척추외과학회지 Vol.3 No.1

The spinal fusion in a lumbar region may influence biomechanically in the remained mobile segment to take over the lost motions Therefore the stress concentration on the adjacent segments may accelerate the degenerative changes, and then various late changes could occur. The aim of this study was to evaluate the late changes occuring in the adjacent segments to lumbar fusions. A retrospective review of radiographs and medical records was undertaken for 67 consecutive patients who had undergone various fusions in the lumbar region for various pathologic conditions. Included in this study were the patients who had performed active daily livings without any significant pain or disability after fusion and followed for a minimum of five years(up to 18 years with a mean of 8.3 years). The results of this study were as follows : The instability, disc narrowing, spinal stenosis, vertebral slipping, or isthmic defect were found in the adjacent segments to fusions in the patients who were followed longer, in L4-5 segment and above segment of fusion, and in the adjacent segments where a degenerative changes existed before surgery and where the angular motion increased considerably in a few years after fusion. The symptoms of these patients were responded well with conservative theraphy and no patient needed any surgical theraphy during these follow-up periods.

고교 3학년 학생의 요통에 관한 역학적 조사

김홍태,유찬훈,정재호,장세앙,최인학 대한척추외과학회 1996 대한척추외과학회지 Vol.3 No.2

The low back pain in children has been knwon to be uncommon and has been regarded as a serious problem if any. The low back pain in students, however, has shown a high prevalence in several surveys. Practically, the education system in Korea concerns a serious health problems, praticularly the low back hygiene. The purposes of this study were to evaluate the prevalence rate and the related factors to LBP, and to seek a preventive measure of this low back pain. Authors underwent a questionaire survey for 1,525 18-year-old high-school students who were impending their graduation from five boys and five girls high-schools in Taegu, Korea with concerning their low back pain The lifetime prevalence rate of low back pain among these students was 73.2% with higher prevalence in girls compared with boys and higher prevalence with advancing school grade. Higher prevalence was also noted in the students who have been involved in less sports activities, who have studied hard, and who have history of low back pain among their families. The steady sitting for study in forward leaning on the uncomfortable school chair and table was suggested to be a main factor related to the low back pain. Most of the low back pain disturbed their attempts at study for entrance examination into college. In conclusion, the prevalence rate of low back pain in high-school students were considerably high and a preventive measure is supposed to be urgent. Regarding these results, most of the low back pain in students may be preventable by regular exercise during school life and by and education of good sitting posture on the comfortable school chair and table during their study.

교합성 골수강내 금속정 제거술중 발생한 경골 골절 - 5례 보고 -

김홍태,김현민,변영수,유찬훈,박연민,전수열 대한골절학회 1999 대한골절학회지 Vol.12 No.3

We have experienced five cases of intraoperative fracture of the tibia assoicated with removal of ACE interlocking tibial nail. All fractures occured in young patients whose ages ranged from eighteen to twenty-nine years(mean, 24 years). We think the main reason of the fracture was characteristic design of ACE nail such as prominent distal angulation and posterior longitudinal slot. The other factors were age of the patient, material of the nail and timing of removal of the nail. In conclusion, we advise caution in the removal of the ACE reamed interlocking intramedullary tibial nail in young patient.

진구성 흉쇄관절 후방탈구 치험례

김홍태,박봉훈,변영수,유찬훈,김형표 최신의학사 1990 最新醫學 Vol.33 No.10

유관 나사를 이용한 대퇴골 경부 골절의 치료

신상철,김홍태,변영수,유찬훈,장병두,현경훈 대한골절학회 2000 대한골절학회지 Vol.13 No.3

Purpose: This study was performed to evaluate the results of femoral neck fractures in adult treated with cannulated screws and the factors that may affect results. Materials and Methods: From April 1992 to December 1998, the authors analysed 53 cases of femoral neck fracture treated with cannulated screws and followed more than one year. According to Garden's classification and anatomic location, we classified the fracture type. We used Garden alignment index for the accuracy of reduction and Singh index for the degree of osteoporosis. The clinical results were analysed by Lunceford's assessment. Results: According to Lunceford's assessment, the results were good or excellent in 40 cases(75%). Mean bony union time was 16.3 weeks. There were 10 cases(19%) of avascular necrosis of the femoral head, 6 cases(11%) of nonunion and 2 cases(4%) of malunion. There were significant relationship between complication rate and accuracy of reduction(P$lt;0.01), operative delay more than 7 days(P$lt;0.05). Conclusion: The important factors that may affect the results are accuracy of reduction and interval between injury and time of operation, the others were degree of displacement, anatomic site, degree of osteoporosis. The results of this study indicate that cannulated screw fixation is an effective method for femoral neck fractures in adult.