족관절의 Bosworth 골절-탈구 발생한 전방 구획 증후군 -증례 보고-

정형진,박세진,최윤석,Chung, Hyung-Jin,Park, Se-Jin,Choi, Yun-Seok 대한족부족관절학회 2004 대한족부족관절학회지 Vol.8 No.2

Bosworth fracture-dislocation of ankle is very rare, occurred by eversion and external rotation force. It is known as irreducible fracture by closed method. Also, compartment syndrome after ankle fracture are exceedingly rare. There are only a few reported cases of compartment syndrome after ankle fracture and compartment syndrome are involved commonly deep posterior compartment. We present a case in which a patient had a Bosworth fracturedislocation of the ankle underwent open reduction with internal fixation and subsequently occurred an anterior compartment syndrome of the leg.

광범위 외측 도달법을 이용한 관절내 종골 골절의 수술적 치료

정형진,안종국,배서영,정훈,Chung, Hyung-Jin,Ahn, Jong-Kuk,Bae, Su-Young,Jung, Hoon 대한족부족관절학회 2009 대한족부족관절학회지 Vol.13 No.1

Purpose: This study was designed to investigate the usefulness of extensile lateral approach for accurate reduction and rigid internal fixation in comminuted intraarticular fractures of calcaneus. Materials and Methods: From October 2002 to May 2007, we managed 55 patients (62 cases) with open reduction and internal fixation using extensile lateral approach. Among these, 38 patients (43 cases) who underwent preoperative and postoperative CT scan were enrolled. All patients were evaluated over 24 months after surgery. Bohler angle and Gissane angle on plain X-ray, displacement and step-off of articular surface of calcaneus on CT scan were measured and we compared the difference between preoperative and postoperative value of them. Clinical results were assessed by using AOFAS Ankle-Hindfoot Scale. Results: The average Bohler angle was restored from $6.8^{\circ}$ to $23.5^{\circ}$ and Gissane angle was improved from $116.4^{\circ}$ to $113.5^{\circ}$ after operation. The average distance of displacement was restored from 4.2 mm to 1.4 mm and step-off of articular surface was recovered from 5.1 mm to 1.3 mm. Clinical results were excellent in 17 cases, good in 18 cases, fair in 3 cases, and poor in 5 cases. 10 cases developed postoperative complications such as skin necrosis, heel pain, limitation of motion of ankle and subtalar arthritis. Conclusion: The extensile lateral approach is valuable for the comminuted intraarticular fractures of calcaneus that enables accurate anatomical reduction and rigid internal fixation by providing direct exposure of subtalar joint.

국소 스테로이드 반복 주사후 발생한 자발적 아킬레스건 파열 -증례 보고-

정형진,최정윤,Chung, Hyung-Jin,Choi, Jung-Yun 대한족부족관절학회 2004 대한족부족관절학회지 Vol.8 No.2

It is known that steroids increase the risk for tendon ruptures. Despite this local steroids are still used in the treatment of achilles tendinitis. 46-year-old women had occurred achilles tendon rupture after repeated local steroid injection. Intraoperatively, necrotic change were seen at both side of ruptured end. Like this, tendon rupture after repeated steroid injection often result in a large defect, which needed surgical repair. After debridement of ruptured end, tenorrhaphy with single Krackow method and plantaris tendon augmentation was done. The patient showed favorable result with return to range in a degree of activity levels.

관절내 종골 골절 및 합병증에 대한 치료

정형진,한용택,송승택,이창수,Chung, Hyung-Jin,Han, Yong-Taek,Song, Seung-Taek,Lee, Chang-Soo 대한족부족관절학회 2003 대한족부족관절학회지 Vol.7 No.1

Purpose: The treatment of calcaneal fractures remains a controversy in orthopaedic field because of its complications. The purpose of this study is to evaluate the efficacy of the treatment of calcaneal fractures and its complications. Materials and Methods: Clinical and radiological results were retrospectively analyzed in 28 patients, 34 cases with fractures of calcaneus which were treated in our department from September 1998 to march 2003. Results: According to the Creighton-Nebraska Foundation Assessment score, there were 3 excellent, 11 good, and 12 fair 6 poor results. Bohler angle was corrected from $8.3^{\circ}$ to $18.3^{\circ}$, Gissane angle was corrected from $121^{\circ}$ to $135^{\circ}$, and calcaneal width was corrected from 46.8mm to 37mm. Conclusion: Open reduction and internal fixation for joint depression type calcaneal fractures thought to be a good method of treatment. Closed reduction and percutaneous axial pinning should be chosed in selected cases of tongue type fractures. In treatment of complicated calcaneal fractures as malunion, subtalar distraction arthrodesis and lateral wall exostectomy will reduce disability of the disease.

족관절 골절과 동반된 전하 경비 인대 견열 골절의 치료

정형진,배서영,김만영,Chung, Hyung-Jin,Bae, Su-Young,Kim, Man-Young 대한족부족관절학회 2011 대한족부족관절학회지 Vol.15 No.1

Purpose: To evaluate the clinical results of anteroinferior tibiofibular ligament avulsion fracture accompanied ankle fractures treated with anatomical reduction and internal fixation. Materials and Methods: From January 2007 to April 2010, 30 cases with anteroinferior tibiofibular ligament avulsion fracture that treated with anatomical reduction and internal fixation were analyzed. The average follow-up period was 26 months (minimum 6 months). We have reviewed the bony union, complication and subjective satisfaction according to the fracture classification and method of internal fixation. Results: Among 30 cases, 28 cases were occurred in Lauge-Hansen classification supination-external rotation type, one case was fracture-dislocation and one case was Maisonneuve fracture. We have performed internal fixation with Mini screw in 11 cases, K-wire in 10 cases, repair in six cases and Mini screw & K-wire in three cases. In all cases bony union was completed. two cases in Mini screw, one case in K-wire, two cases in repair and one case in Mini screw & K-wire revealed LOM of ankle joint. Skin irritation and superficial peroneal nerve irritation happened in one case each. Other cases show good subjective satisfaction. Conclusion: Anteroinferior tibiofibular ligament avulsion fracture accompanied with ankle fracture is a good clinical outcome with internal fixation. So we should not miss out the anteroinferior tibiofibular ligament avulsion fracture in radiologic evaluation or operation room.

족관절 골절 치료에 사용한 금속 내고정물 제거 수술 시 시행한 균 배양 검사의 결과

정형진,배서영,유재하,Chung, Hyung-Jin,Bae, Su-Young,Yu, Jae-Ha 대한족부족관절학회 2014 대한족부족관절학회지 Vol.18 No.2

Purpose: The purpose of this study is to report the results of culture test at the time of removal of metal devices used for management of ankle fractures and for analysis of contributing factors. Materials and Methods: We reviewed medical records of 132 patients with lower tibia and ankle fracture who had their metal devices removed during the period from January 2010 to February 2014. Patients with clinical signs of infection were excluded. Culture test was performed by taking the granulation tissue around the metal device at the time of removal. We divided the subjects into two groups, culture positive and negative. We then performed a retrospective review of each medical record of multiple factors that might contribute to the culture results, including laboratory results, medical history, material and size of metal device, indwelling period, and whether or not it was open injury. Results: Among 132 cases, six were culture positive. Enterococcus was detected in two cases and the others were Staphylococcus. No significant difference in medical history of patients and laboratory results, including C-reactive protein level, was observed between the culture positive and negative group. Culture positive rate was 5.4% in titanium and 3.9% in stainless steel. In terms of metal size, culture positive rate was 5.1% in small plates, 6.7% in large plates, and culture negative in intramedullary nails. The average indwelling period of metal device was 61.5 weeks in the culture positive group, and 68.6 weeks in the negative group. Nine cases were open fractures and all were in the culture negative group. Conclusion: Whether or not the culture result was positive, there were no meaningful contributing factors. Presence of bacterium on the metal device could not be screened by any laboratory results or other factors.

아킬레스건 파열에 대한 수술 후 조기 재활 치료

정형진,박준석,김현호,박용원,Chung, Hyung-Jin,Park, Joon-Suk,Kim, Hyun-Ho,Park, Yong-Won 대한족부족관절학회 2003 대한족부족관절학회지 Vol.7 No.1

Purpose: The purpose of the study is to evaluate the clinical outcomes of acute achilles tendon rupture patients treated by early mobilization after operative repair. Materials and Methods: In this retrospective study, 12 patients of acute Achilles tendon rupture were surgically treated from May 2001 to November 2002, with follow-up period of at least 6 months. There were 10 men and 2 women, and mean age was 35.9 year. The repair method was single Krackow suture technique. Two to three weeks after the operation, early ROM with removable ankle-foot orthosis(AFO) was started. We used Amer-Lindholm scale for the clinical evaluation and analyzed patient's satisfaction and subjective strength deficit. Results: We had 11 excellent results(92%), and 1 good results(8%). One-leg heel raising was possible in all patients. All the patients returned to the preinjury occupations and 7 patients(58%) reached the preoperative level of sports activities. There was no significant difference in ankle ROM and ankle plantar flexion isokinetic strength compared to contralateral side. There was, no reruptures. Conclusion: Early mobilization proved to be a well tolerated, safe, and effective means for the compliant patient.

통증성 제1,2 중족골간 부골 - 증례보고 -

정형진,김현호,Chung, Hyung-Jin,Kim, Hyun-Ho 대한족부족관절학회 2002 대한족부족관절학회지 Vol.6 No.1

The os intermetatarseum is a relatively uncommon bony anomaly of the foot. It is usually found between the bases of the first and second metatarsal bones and ossifies during adolescence. It is most commonly seen in radiographs as a separated ossicle, but it may arise as a spur from the base of the first or second metatarsal bone or from the medial cuneiform bone. It sometimes articulates with the base of the first or second metatarsal bone. We treated a painfull os intermetatarseum by excision, and had a good result after 13months follow-up.

당뇨병성 샤콧 관절의 치료

정형진,Chung, Hyung-Jin 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.4

다시 강조하지만 신경관절병증의 수술 목표는 정상발을 만드는 것이 아니라 보조기 착용이 가능하고 발바닥을 이용한 체중 부하 보행이 가능하도록 하는 것이라는 것을 늘 유념하여 치료 계획을 세워야 한다. 따라서 적절한 수술 방법을 선택하기 위해서는 병의 진행 경과와 특성을 이해하여 적절한 술 전 계획을 수립하는 것이 가장 중요할 것이다. Diabetic Charcot arthropathy is a severe joint disease in the foot and ankle that can result in fracture, permanent deformity, limb loss. Although recent research has improved our level of knowledge regarding its etiology and treatment, it still remains a poorly understood disease. It is a serious and potentially limb-threatening lower-extremity late complication of diabetes mellitus and its diagnosis is commonly missed upon initial presentation. Clinicians treating diabetic patients should be vigilant in recognizing early signs of acute Charcot arthropathy, such as pain, warmth, edema, or pathologic fracture in a neuropathic foot. Early detection and prompt treatment can prevent joint and bone destruction. If left untreated, it can reduce overall quality of life and dramatically increase morbidity and mortality of patients. The goal of this manuscript is to evaluate the current concepts of Charcot arthropathy through review of various literature and help clinicians decide the treatment strategy.

아킬레스건 파열과 동반된 동측 족관절 양과 골절(1예 보고)

정형진,배서영,민병권,송민철,Chung, Hyung-Jin,Bae, Su-Young,Min, Byoung-Kwon,Song, Min-Cheol 대한족부족관절학회 2011 대한족부족관절학회지 Vol.15 No.2

We report here on a case of Achilles tendon rupture associated with ipsilateral bimalleolar fracture that was caused by ski injury. The association of an ankle fracture with rupture of the Achilles tendon is even more infrequent, although both injuries alone are extremely common. We treated as a operation of Achilles tendon repair with Krackow method and open reduction with Tension-band wiring technique for bimalleolar fracture.