전방 십자 인대 수술 후 합병된 슬관절 강직 - 원인분석 및 치료 -

최남용,이인주,최문구,고해석,김승기,박성진,한석구,강영목,Choi, Nam Yong,Lee, In Ju,Choi, Moon Ku,Ko, Hae Sok,Kim, Seung Ki,Park, Sung Jin,Han, Suk Koo,Kang, Young Mok 대한관절경학회 1998 대한관절경학회지 Vol.2 No.1

Between March 1992 and December 1995 at St. Paul's, Holy Family, St. Vincent and Eui Jung Bu St. Mary Hospitals Catholic University, two hundred and eighty patients underwent arthroscopic anterior cruciate ligament(ACL) reconstruction using central one-third bone-patellar tendon-bone autograft. Nine of these patients had limitation of motion(LOM) defined as a knee flexion contracture greater than 10o or less than 125o of passive knee flexion. This study analyzes the causes of LOM after ACL reconstruction as well as the results after passive manipulation or arthroscopic adhesiolysis under anesthesia for LOM. The results are as follows: 1. Out of nine patients, initially three had isolated ACL injuries and six had combined injuries. Seven of nine cases were perfomed by ACL reconstruction within four weeks and two were performed after four weeks following injury. 2. Treatment for LOM after ACL reconstruction was done after 5.5 months on average. 3. Arthroscopic adhesiolysis was done in 5 cases. There were fibrous adhesions at suprapatellar pouch and femoral intercondylar notch in all cases, respectively, infrapatellar fat pad in 3 cases and medial para patellar gutter in 2 cases. Two patients had a fibrous nodule, "cyclops" lesion, which formed anterior to the ACL graft. 4. Range of motion and Lysholm knee score were much improved following passive manipulation or arthroscopic adhesiolysis under anesthesia for LOM.

외상과 비외상에 의한 슬관절 반월상 연골의 파열 형태

손종민,김형관,장주해,최문구,문찬웅,Sohn, Jong-Min,Kim, Hyoung-Gwan,Jahng, Ju-Hae,Choi, Moon-Ku,Moon, Chan-Woong 대한관절경학회 1998 대한관절경학회지 Vol.2 No.2

We reviewed the charts and photos taken during arthroscpy of 218 knees of 214 patients(240 menisci) retrospectively. The male was 156 cases(73%) and the female 58 cases(27%). The mean age of the patients was 35 years(range, 7-68). The patients who had definite trauma history were classified as trauma group(Group 1), and the patients who had no or could not recall trauma history were as atrauma group(Group 2). The trauma group was subclassified into the the patients with sports injury, traffic accident, fall down, slip down, direct injury, and miscellaneous according to the causes of the trauma. The patterns of meniscal tear were classified into longitudinal, bucket-handle, horizontal, transverse, flap, complex, and degenerative tear on the basis of O'Connor's classification. The aim of this study was to compare the meniscal tear patterns between trauma group(Group 1) and atrauma group(Group 2) and between the patients before and after the age of 40. The results were as follows ; 1) The difference in the incidence of tear between medial and lateral meniscus was not significant statistically. 2) In Group 1, 60% of the cases showed the longitudinal and bucket-handle tear and 52% of the cases of Group 2 were horizontal tear. 3) In the patients before the age of 40, the longitudinal and bucket-handle tear were 52% of the cases and in the patients over 40, tear patterns which were thought to be related to degenerative change, horizontal and degenerative tear were more than half of the cases (51%).

수근관절 주위의 진구성 전기감전 손상에 대한 단계적 재건술

김형민(Hyoung Min Kim),최문구(Moon Ku Choi),이기행(Gee Heng Lee),정창훈(Chang Hoon Jung),송현준(Hyun Jun Song) 대한정형외과학회 1997 대한정형외과학회지 Vol.32 No.2

골반골 전상 장골극 절골술을 이용한 Iliofemoral 도달변법

김형민(Hyoung-Min Kim),김윤수(Youn-Soo Kim),주인탁(In-Tak Choo),최문구(Moon-Gu Choi),한석구(Suk-Ku Han) 대한정형외과학회 1995 대한정형외과학회지 Vol.30 No.3

급성 견봉쇄골관절 탈구의 수술적 치료

최남용,이인주,이영채,최문구,김한진,신종욱 대한골절학회 1995 대한골절학회지 Vol.8 No.1

Thirty-one patients who had a acromioclavicular joint dislocation that were treated by surgical operation, between January 1990 and Decemer 1993 at St. Paul's k Holy Family hospital were analyzed. The results are as follows; 1. There were twenty-five males and six females. The mean age was 33 years, ranging from 17 to 52 years old. 2. Out of thirty-one cases, twenty-six had good to excellent functional results. 3. As regards complication, wire migration occurred in two cases, wire breakage in one case, screw loosening in one, and subluxation following wire or screw removal in four.

대퇴골 원위부 과 골절의 수술적 치료

김윤수,이기행,김형민,정창훈,최문구,권중혁 대한골절학회 1999 대한골절학회지 Vol.12 No.3

Purpose: To evaluate the results of the the condylar fracture of the femur treated by open reduction and cancellous screw fixation. Material and Methods: From April, 1994 to October, 1998, 9 cases of the condylar fracture of the femur were open reduced and internally fixed with cancellous screw. According to AO classification, B2 type, B3 type and C2 type were all three cases each. All intraarticular fragment of the 9 cases were fixed with cancellous screws fixation after open reduction. Additionally 2 cases were fixed with dynamic condylar screw and 1 case was fixed with supracondylar nail. Authors followed up from shortest one year one month to longist three year four month (average 2 years) and evaluated them by using the method of Schatzker and Lambert' s. Results: Seven of 9 cases had reduced anatomically, and remained 2 case which were delayed to operation cannot reduced anatomically. In all case stable fixation of the intraarticular fragment was obtained by cancellous screw fixation without perioperative complication, Schatzker and Lambert s assesment shows excellent in four, good in one, fair in three and failure in one case. Conclusion: In case of the condylar fracture of the femur, early and relatively simple screw fixation can obtain anotomical reduction and prevent complication caused by incongruent joint surface.

대퇴골 간부 불유합의 원인 및 치료

김윤수,이기행,김형민,최문구,박영주,송홍화 대한골절학회 1996 대한골절학회지 Vol.9 No.1

The causes of nonunion of the femur shaft could be divided as fracture itself and iatrogenic, And also the methods of treatment are controversial. From Dec. 1988 to Jan. 1995, we analysed 21 cases of nonunion of the femur shaft. The period of follow up was from 1 year to 4 year 7 month( average time 2 years). The causes of the nonunion were fracture itself in 1 case, inadequate fixation in 17 cases, and early weight bearing in 3 cases. Seventeen of 21 were plate fixation cases and 4 or 21 were intramedullary nailing cases. Metallic failure were seen in 15 cases. Cancellous bone graft was done in all cases. Cancellous bone graft only without other additional fixation were done in two cases, plate fixation were done in 8 cases, and intramedullary nailing were done in 11 cases. Additional narrow plate fixation were done in 9 cases which 3 cases were done with plate fixation and 6 cases were done with intramedullary nailing. Partial weight bearing were done 2.5 months in which case cancellous bone graft only, plate fixation and intramedullary nailing cases, were done 2 months in the case of narrow additional plate with intramedullary nailing. Authors concluded that stable internal fixation was very important and additional narrow plate fixation was good alternative method in the treatment of nonunion of the femur shaft.

경골외과 골절의 외측 반월상 연골판 절개를 이용한 도달법

이기행,김형민,정창훈,최문구,송현준 대한골절학회 1997 대한골절학회지 Vol.10 No.1

Exposure to the posterolateral comer of the tibial condyle was difficult due to narrow joint space and meniscus. From l995. 1. to l996. 4.. the authors operatively reduced and internally fixed 9 cases of lateral tibial plateau fractures using lateral meniscal incision with minimal detatchment and retraction to improve visualization posterior aspect of articular cartilage Eight of the 9 cases were studied with three dimentional computerised tomogram and 1 case with roentgenographic tomogram to evaluate the shape, site and degree of comminution of the fracture fragments. ROM exercise was started at weeks postopratively, manipulation under anesthesia were done in 3 cases at 12 weeks postoperatively. The follow up period was 13 months (from 8M to lyr 11M). The results were obtained as follows, 1. Seven cases were split depression type, one was pure depression type and one was bicondylar type. 2. Articular depression were posterolateral aspect in 8 cases, and lateral aspect in one case. The degree of depression was average 15 mm(range from 6mm to 22mm). 3. Six of the 9 cases had peripheral tear of the lateral meniscus 4. Second look arthroscopy shows that the incision site of the meniscus were thinned but completely healed in 3 cases. 5. The ROM of the knee joint were 0 - over l35 in seven cases. 0° - 90° in one case, 30- 60° in one case. This meniscal incision approach was one of the effective methods that provides exposure of the entire articula surface of the lateral tibial condyle easily to allow accurate reduction.

견갑골 체부 골절의 수술적 치료

김윤수,이광열,이기행,김형민,정창훈,최문구 대한골절학회 1999 대한골절학회지 Vol.12 No.3

Purpose: Although fracture of the body of the scapula have been treated successfully by conservative treatment but residual deformity was high and related to the residual symptom. Authors had done open reduction and internal fixation with wiring in the case of severe displacement of the fracture fragment of the body of scapula and analyzed that results. Material and Methods: Authors treated 18 cases of fracture of the body of the scapula in 17 patients from October, 1985 to June, 1996. Conservatively treated group was 12 cases which has less than 2cm displacement and operatively treated group was 6 cases which has more than 2cm displacement of the fracture fragment. Internal fixation was done with wiring. All cases was followed up average l year 9months (from 13months to 8year 8months) and evaluated by McGinnis assessment system. Results: All cases united within ten weeks. Five cases in the operatively treated six cases got anatomic reduction and stable fixation with wiring and had no operation related complication. Operatively treated group has average 2.83 associated injury and conservatively treated group has average 1.87. Neurovascular complication compromised the results. Conclusion: Operative treatment of the fracture of the scapular body can reduce the residual deformity and residual symptom in the severely displaced case and facilitate early rehabilitation.