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종골 부정 유합에 동반된 거주상 관절 아탈구의 치료 (1예 보고)
차성무,장보훈,서진수,Cha, Seong-Mu,Chang, Bo Hoon,Suh, Jin-Soo 대한족부족관절학회 2012 대한족부족관절학회지 Vol.16 No.4
There may be complications after comminuted or intraarticular calcaneal fracture regardless of the initial treatment. Transcalcaneal talonavicular dislocation is rarely reported severe form of calcaneal fracture. We experienced a neglected transcalcaneal talonavicular subluxation case, who had been treated for intraarticular calcaneal fracture conservatively. Subtalar distraction bone block fusion was done for calcaneal malunion with talonavicular subluxation. Inspite of successful subtalar fusion, pain was persisted because of talonavicular re-subluxation with arthritis and calcaneocuboid arthritis. So, second operation, the talonavicular and calcaneocuboid fusion, was done. After union achieved, the patient's foot pain was improved. Calcaneal malunion combined with talonavicular subluxation and unstable transverse tarsal joint, such as this case, initial triple arthrodesis could be considered.
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차성무(Seong Mu Cha),장보훈(Bo Hoon Chang),서진수(Jin Soo Suh) 대한정형외과학회 2013 대한정형외과학회지 Vol.48 No.2
목적: 급성 아킬레스 건 파열에 대한 수술적 치료 후 단일 하지 거상 시기 및 족저 굴곡 근력 측정을 하여 근 재활의 경과를 분석하고자 하였다. 대상 및 방법: 2006년 3월부터 2011년 6월까지 본원에서 급성 아킬레스 건 파열로 수술적 치료를 시행한 81예 중 조건에 합당한 39예의 환자를 대상으로 하였다. 수술과 재활은 일정하게 진행하였으며, 수술 3개월째 근력 검사 및 단일 하지 거상 시기를 측정하여, 최종 추시의 임상결과와 함께 분석하였다. 결과: 단일 하지 거상 시기는 평균 14주+3일이었고 수술 후 3개월째 시행한 등속성 족저 굴곡력 검사에서 30o/s 각속도의 최대 우력은 평균 69 Nm, 120o/s 각속도의 최대 우력은 평균 41 Nm로 건측의 69%로 측정되었다. 수술 후 3개월 이내에 단일 하지 거상이 가능하였던 군에서 최종 추시의 Achilles tendon total rupture score, Foot and ankle outcome score가 통계적으로 유의하게 높았다. 결론: 아킬레스건 파열 후 재활 과정에서 단일 하지 거상이 일찍 가능하면 근력 회복이 좋음을 기대할 수 있고, 최종 추시의 임상 결과가 좋음을 예측할 수 있으리라 생각한다. Purpose: The purpose of this study is to analyze the progress of muscle rehabilitation for patients with acute Achilles tendon rupture, who underwent Achilles tendon repair, checking capable time of single heel raise and isokinetic plantar flexion power. Materials and Methods: From March 2006 to June 2011, 42 of 81 patients were excluded and the other 39 patients, who underwent surgery due to acute Achilles tendon rupture in our institute, were enrolled in this study. The operation and rehabilitation were constantly performed according to the author’s method. Isokinetic plantar flexion power was measured at three months postoperation, capable time of single heel raise was assessed, and clinical results of the last follow up were measured and analyzed. Results: Single heel raise was possible at an average of 14 weeks and three days, and repetitive single heel raise more than 10 times was possible at an average of 20 weeks. The peak torque of 30°/s plantar flexion was mean 69 Nm. The peak torque of 120°/s was 41 Nm. Assessment at three months post-operation showed 69% power, compared to the contralateral leg. The group of patients who were able to perform single heel raise within three months, showed better Achilles tendon total rupture score and foot and ankle outcome score at last follow up, and showed better plantar flexion power at three months post-operation. Conclusion: At the last follow up, we can expect better clinical results and muscle power in patients who are able to perform single heel raise early treatment of acute Achilles tendon rupture.
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슬개골 골절의 경피적 핀 고정술 후 지연 발생한 재발성 혈관절증
조진호 ( Jin Ho Cho ),왕국현 ( Kook Hyun Wang ),장보훈 ( Bo Hoon Chang ),나경욱 ( Kyung Wook Nha ),( Smarajit Patnaik ) 대한슬관절학회 2011 대한슬관절학회지 Vol.23 No.1
A 24-year-old man underwent percutaneous fixation with pins for an undisplaced patellar fracture. At 7 months follow-up postoperatively, he presented with recurrent, painful swelling of the operated knee following trivial activities of daily life. Aspiration had been performed two times before he presented to us with symptoms. An x-ray showed that one of the pins was suspected to be protruding at the inferior pole of the patella. Magnetic resonance imaging confirmed effusion in the joint. Arthroscopy revealed that the pin was prominent intraarticularly, and the adjacent infrapatellar fat pad with surrounding synovial tissue seemed to be abraded. The pins were removed under arthroscopic guidance and any pain or hemarthrosis disappeared thereafter.
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