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고한석,최덕신,하정구 인제대학교 백병원 2002 仁濟醫學 Vol.23 No.2
Purposes: To evaluate the clinical and radiological results of the surgical treatment without internal fixation for the unstable intertrochanteric fracture. Materials and Methods: We treated 34 cases of unstable intertrochanteric fractures with compression hip screw without internal fixation of lesser trochanter from April 1998 to August 2000. By Tronzo classification, 30 cases were type Ⅲ, 2 cases were type Ⅳ and 2 case were type Ⅴ. We fixed lesser trochanter fracture fragment in 8 cases. In 26 cases, there were no internal fixation of lesser trochanter. Clinical outcome was assessed by Kyle's assessment criteria, Radiographically. We measured tipapex distance preoperatively and union time and sliding length during follow-up period in two groups. Results: There were no statistically significant difference in radiographic bone union time and tip-apex distance change in two groups. Mean sliding length of screw was 6.0㎜ in patients with fixation of lesser trochanter, and 9.3㎜ in patients without fixation. Clinical assessment using Kyle' criteria showed excellent or good result in 8 cases in patients with fixation and 24 patients without fixation. Conclusion: Surgical treatment using compression hip screw without internal fixation of lesser trochanter for unstable intertrochanteric fracture can obtain similar results clinically and radiographically.
단순 방사선 상에서 발견할 수 없었던 거골 골연골 병변의 MRI 소견과 관절경 소견
이우천,심재찬,최덕신,Lee, Woo-Chun,Shim, Jae-Chan,Choi, Deog-Shin 대한족부족관절학회 2002 대한족부족관절학회지 Vol.6 No.2
Purpose: To investigate the MRI and arthroscopic findings of osteochondral lesion of the talus which looked normal on plane radiography. Materials and methods: We investigated the MRI and arthroscopic findings of seven osteochondral lesions in which there were no abnormal finding on plane radiography and no cystic changes on MRI. Average age was 31 years(range, 19-43 years). Arthroscopic findings were classified according to the Ferkel's criteria. Results: History of injury was reported in all cases and the average duration from injury to presentation was 4 years and 4 months. Low signal change in T1WI was found in 6 of 7 lesions, no signal change in 1 case. Low signal change in T2WI was found in 4, no signal change in 3. 6 STIR images were obtained. High signal change was found in 3, no signal change in 2 and intermediate signal change was in 1. Arthroscopic grading was A in 1, C in 1, D in 2 , E in 1 and F in 2. We could not find any correlation between the findings on MRI and arthroscopic examination. Conclusion: We suggest arthroscopic examination is needed for accurate diagnosis of the osteochondral lesions of the talus which looked normal on plane radiography, because they have various MRl findings and high likelihood of existence of unstable cartilage lesions.