손목에서 발생한 요골 동맥의 외막 낭포 - 1예 보고 -

강수환,박일중,김동엽,김광섭,Kang, Soo Hwan,Park, Il-Jung,Kim, Dong Yeob,Kim, Kwang Sub 대한미세수술학회 2011 Archives of reconstructive microsurgery Vol.20 No.2

Simple ganglions are most common benign tumor of the hand and wrist. However, cystic adventitial disease is an uncommon vascular anomaly first described in 1947 in the external iliac artery. It usually involves the popliteal artery, although other arteries and veins may also be involved. Radial artery adventitial cysts are found directly within the adventitia, whereas the more common wrist ganglions may extrinsically compress or adhere to the artery walls. The diagnosis is rarely made before surgery because of their similar appearance and location. The authors report a rare case of a 46-year old woman with mucoid adventitial cyst of the radial artery in the wrist.

중등도 무지 외반증 환자에서 원위부 갈매기형 절골술과 중족골 근위부 폐쇄성 쐐기 절골술의 치료 결과 비교

정창훈,박일중,김윤수,이기행,문찬웅,이경훈,김형민,Jeong, Chang-Hoon,Park, Il-Jung,Kim, Youn-Soo,Lee, Kee-Haeng,Moon, Chan-Woong,Lee, Kyung-Hoon,Kim, Hyoung-Min 대한족부족관절학회 2008 대한족부족관절학회지 Vol.12 No.2

Purpose: The purpose of this study is to compare the treatment outcomes of distal chevron osteotomy with those of proximal metatarsal closing wedge osteotomy in patients with moderate severity hallux valgus. Materials and Methods: Forty-two patients (51 feet) who were underwent either distal chevron osteotomy (Group I, 22 patients, 27 feet) or proximal metatarsal closing wedge osteotomy (Group II, 20 patients, 24 feet) for the correction of moderate hallux valgus deformity were evaluated retrospectively. We assessed the radiographic results with several parameters including hallux valgus angle (HVA), intermetatarsal angle (IMA) and distal metatarsal articular angle (DMAA). And clinical results with modified AOFAS score at last follow-up. Results: There were no significant differences in IMA, HVA and DMAA between two groups preoperatively. We can achieve the good results with both procedures, but mean HVA and IMA of group II was significantly lower than those of group I. There was some loss of correction in group I at the last follow-up. There was no significant difference in clinical results according to modified AOFAS scoring between two groups at the last follow-up. Conclusion: The proximal metatarsal closing wedge osteotomy for the hallux valgus with moderate severity is better treatment option to achieve better radiographic correction and to prevent loss of correction or recurrence than distal chevron osteotomy.

주관 증후군의 수술적 치료: 척골 신경의 전방 근하 전위술과 전방 근막하 전위술의 비교

강수환,송석환,박일중,이상욱,이승구,박승범,Kang, Soo-Hwan,Song, Seok-Whan,Park, Il-Jung,Lee, Sang-Uk,Rhee, Seung-Koo,Park, Seung-Bum 대한미세수술학회 2008 Archives of reconstructive microsurgery Vol.17 No.1

Surgical treatment of compressive ulnar neuropathy at the elbow has been performed with a wide variety of techniques. Among these techniques, anterior submuscular transposition of the ulnar nerve has been regarded as the method of choice by many authors. It has many advantages including a low recurrence rate, scar-free vascular bed, and protection from repeated trauma to the nerve. However, anterior submuscular transposition is technically demanding and requires more extensive soft tissue dissection. On the other hand, anterior subfascial transposition is less invasive, requires a relatively shorter operation time than the submuscular technique, and also can be done safely even in patiensts with elbow arthritis. We evaluated the clinical results of anterior submuscular transposition compared with anterior subfascial transposition. Fifteen patients underwent anterior submuscular transposition and ten patients underwent anterior subfascial transposition of the ulnar nerve. The mean follow-up time was 15 months (range 10 to 38 months) in the anterior submuscular transposition group and 7 months (range 6 to 15 months) in the anterior subfascial transposition group. According to the outcome status determination algorithm devised by Mowlavi, 3 patients (20%) showed total relief, 10 patiensts (66.7%) improvement and 2 patients (13.3%) no changes in the anterior submuscular transposition group. In the anterior subfascial transposition group, 2 patients (20%) showed total relief, 7 patients (70%) improvement and 1 patient (10%) displayed no changes. Statistically there was no significant difference of the clinical results between the two surgical techniques. Therefore we would suggest anterior subfascial transposition of the ulnar nerve as a preferred method for treatment of cubital tunnel syndrome.

Evaluation of Three Different Reconstructive Techniques for Scapholunate Dissociation

Anna Jeon(전안나),Il-Jung Park(박일중),Seungbum Chae(채승범),Tae Soo Bae(배태수),Dai-Soon Kwak(곽대순) 대한기계학회 2022 대한기계학회 춘추학술대회 Vol.2022 No.11

Evaluation of Three Different Reconstructive Techniques for Scapholunate Dissociation

Anna Jeon(전안나),Il-Jung Park(박일중),Seungbum Chae(채승범),Tae Soo Bae(배태수),Dai-Soon Kwak(곽대순) 대한기계학회 2022 대한기계학회 춘추학술대회 Vol.2022 No.11

전방골간신경 증후군: 수술적으로 치료한 7예에 대한 임상적 고찰

김형민,정창훈,이상욱,노연태,박일중,Kim, Hyoung-Min,Jeong, Chang-Hoon,Lee, Sang-Uk,Roh, Youn-Tae,Park, Il-Jung 대한미세수술학회 2009 Archives of reconstructive microsurgery Vol.18 No.2

Purpose: The etiology and treatment strategy of the anterior interosseous nerve (AIN) syndrome are still controversial. Seven patients with the AIN syndrome who were treated by surgical exploration and neurolysis were reviewed at a mean of 35.9 months follow up period. Materials & Methods: There were six men and one woman. The mean age was 37.3 years, ranging from 26 to 59. No patient was related to trauma and associated neurological lesion. Surgical exploration was performed at 7.7 months after onset of paralysis. Results: All except one patients experienced pain around the elbow region before the onset of the palsy. On 7 patients, only the flexor pollicis longus was paralysed in 1, only the index flexor digitorum profundus in 2, and none had paralysis of the middle. The most common compression structures were fibrous bands within flexor digitorum sublimis arcade. However there was no demonstrable abnormality in three. Recovery was complete in all cases within 12 months after surgery. Conclusion: We recommended surgical exploration and neurolysis in patients who have shown no improvement after 6 months of conservative treatment. And careful preoperative examination is essential to avoid misdiagnosis and inappropriate surgery, especially in incomplete AIN syndrome.

변형된 용수철 금속판을 이용한 불안정 원위 쇄골 골절의 치료

이상명 ( Sang Myung Lee ),박일중 ( Il Jung Park ),김형민 ( Hyung Min Kim ),박재철 ( Jae Chul Park ),조성길 ( Sung Gil Cho ),김윤정 ( Yoon Chung Kim ),이승구 ( Seung Koo Rhee ) 대한골절학회 2010 대한골절학회지 Vol.23 No.1

목적: 불안정 원위 쇄골 골절은 원위 골절편이 작아 고정이 힘들며 현재 다양한 방법이 사용되고 있지만 강한 고정력을 가지며 통증이 적은 방법은 거의 없는 실정이다. 이에 저자들은 변형된 용수철 금속판을 이용하여 불안정 원위 쇄골 골절을 치료하여 그 결과를 보고하고자 한다. 대상 및 방법: 변형된 용수철 금속판은 1/3 관형 금속판의 구멍 원위부를 절단한 후 날카로운 말단이 되도록 쇠줄로 갈고 구부려 C자형의 모양이 되도록 고안하였다. 2007년 5월부터 2009년 6월까지 총 6명의 환자에서 변형된 용수철 금속판을 이용한 내 고정술을 시행하였고, 술 후 6주간 팔걸이를 하면서 조기 견관절 운동을 시행하였다. 결과: 6예의 환자 모두에서 골유합을 얻었으며 견관절 주위 통증과 기능에 대해 Constant score 96점의 좋은 결과를 보였다. 술 후 7주에 모든 환자는 경미한 견관절 외전 제한 외에는 일상생활에 제한이 없었고 술 후 6개월 후 금속판을 제거하였으며 합병증은 없었다. 결론: 변형된 용수철 금속판은 원위 쇄골의 불안정 골절 시 고정력이 강하여 조기 관절 운동을 시행할 수 있고, 견봉-쇄골 관절 및 견봉하 공간, 회전근개 등에 손상을 주지 않아 유용한 방법이라 생각된다. Purpose: Unstable distal clavicle fractures should be treated surgically but may be difficult in firm fixation because of small distal fragment. Although a variety of fixation methods have been currently used, none of the methods seem to be firm fixation and little pain. We present a new technique using a spring plate which was modified from one third tubular plate and report the early results. Materials and Methods: Modified spring plate was made from one third tubular plate and the distal hole of the plate was cutting and sharpened by rasp. The sharp edge was bent just like an animal claw (C shape). Between May 2007 and June 2009, a total of six patients with distal clavicle fracture were treated using modified spring plate. A sling was applied in the immediate post operative period for six weeks and exercises were started immediately. Results: Union was achieved in all cases with excellent results without complication (mean Constant score, 96). All patients had returned to ordinary daily activities but mild limitation of abduction (150˚) by seven weeks after surgery. After six months, the plate was removed. Conclusion: The modified spring plate has provided stable fixation for unstable distal clavicle fixation without disturbance to the acromioclavicular joint, subacromial space, or rotator cuff.

월상 골 제거 및 혈관부착 두상 골 이식으로 치료한 진행된 키엔벡 병

이주엽,김형민,정양국,진성기,박일중,Lee, Joo-Yup,Kim, Hyoung-Min,Chung, Yang-Guk,Jin, Sung-Ki,Park, Il-Jung 대한미세수술학회 2008 Archives of reconstructive microsurgery Vol.17 No.2

Purpose: There are many controversies concerning therapeutic guidelines for the treatment of Kienb$\ddot{o}$ck's disease. The purpose of this study is to evaluate the clinical and radiological result of lunate replacement by vascularized os pisiform transfer in advanced Kienb$\ddot{o}$ck's disease. Materials & Methods: There were two men and three women. The mean age was 55 years, ranging from 41 to 70. According to Lichtman's classification, three cases were stage IIIb and two cases were stage IV. Results: At the period of follow up, pain during motion was markedly diminished in all patients, the arc of motion ranged on average from 49 degrees of flexion to 53 degrees of extension and the grip power of the affected hand reached on average 83% compared with the contralateral side. Clinical results assessed by DASH and modified Mayo score showed 8 and 90. On plain X-rays, carpal height ratio and radioscaphoid angle were not changed postoperatively. Conclusion: Lunate excision and vascularized os pisiform transfer is a reliable alternative method for the treatment of advanced Kienb$\ddot{o}$ck's disease.

도수 정복되지 않는 근위 지간 관절의 개방성 후방 탈구 -증례 보고-

노연태 ( Youn Tae Roh ),박일중 ( Il Jung Park ),김형민 ( Hyoung Min Kim ),이재영 ( Jae Young Lee ),유성림 ( Sung Lim You ),김윤수 ( Youn Soo Kim ) 대한골절학회 2015 대한골절학회지 Vol.28 No.1

근위 지간 관절의 후방 탈구는 정형외과 영역에서 자주 접하는 수부 손상 중 하나이다. 대부분의 경우 단순한 도수 조작만으로도 쉽게 정복이 되나, 드물게 도수 조작으로 정복이 되지 않아 수술적 정복이 필요한 경우도 있다. 저자들은 근위 지간 관절의 개방성 후방 탈구에서 굴곡건에 의하여 도수 정복이 되지 않아 수술적 정복술을 시행한 증례를 보고하고자 한다. 굴곡건이 근위지골의 골두와 중위지골의 기저부 사이에 감입되어 있어 탐침자를 이용하여 굴곡건을 제 위치로 옮긴 후에야 비로소 정복을 얻을 수 있었다. Dorsal dislocation of the proximal interphalangeal joint is a common injury in the orthopedic department. In most cases, the joint is reduced simply by closed manipulation. However, in rare cases, the joint is not reducible by closed manipulation, therefore, surgery is required. We report on a case of irreducible open dorsal dislocation of the proximal interphalangeal joint which was surgically treated. Because the flexor tendon interposed between the head of the proximal phalanx and the base of the middle phalanx, we could reduce the joint only after repositioning of the flexor tendon.

경골의 감염성 불유합 치료 시 보존된 후방 피질 골의 유용성

김형민 ( Hyoung Min Kim ),박일중 ( Il Jung Park ),노연태 ( Youn Tae Roh ),강병민 ( Byung Min Kang ),이현진 ( Hyun Jin Lee ),이재영 ( Jae Young Lee ) 대한골절학회 2014 대한골절학회지 Vol.27 No.4

목적: 경골의 감염성 불유합 치료에서 광범위 변연 절제술 시 골 결손부에 주위 근육이나 골막과의 연속성이 남아있는 후방 피질 골을 보존한 경우 치료의 유용성에 대하여 연구하였다. 대상 및 방법: 2001년 1월부터 2011년 5월까지 경골의 감염성 불유합 진단하에 광범위 변연 절제술 후 분절 결손이 4 cm 이상인 12예를 대상으로 하였다. 골 결손부에 후방 피질 골을 보존한 6예(1군)와 후방 피질 골이 없는 6예(2군)를 비교 분석하였다. 골 결손부의 크기, 변연 절제술 후 골 재건술까지의 기간, 골 유합 시기, 합병증, 임상적 결과를 확인하였다. 결과: 골 결손부의 길이는 1군은 평균 7.6 cm (4.3-11.0 cm)였고 2군은 평균 6.4 cm (4.0-12.0 cm)였다. 변연 절제술 후 골 재건술까지의 기간은 1군은 평균 10.0주(5-18주)였으며 2군은 평균 12.1주(0-24주)였다. 골 유합 시기는 1군은 평균 6.2개월(5-7개월), 2군은 평균 10.8개월(7-18개월)이었다. 합병증은 2군에서 피로 골절이 2예, 신연 골 형성술에서 골 접촉부 불유합이 2예 발생하였다. 결론: 경골의 감염성 불유합에서 광범위 변연 절제술을 시행할 때 후방 피질 골을 보존하는 것이 골 유합을 용이하게 하고 치료기간을 단축하였다. Purpose: We studied the efficacy of preserved posterior cortex connecting to adjacent muscle or periosteum during wide debridement in the treatment of infected nonunion of the tibia. Materials and Methods: From January 2001 to May 2011, 12 cases of infected nonunion of the tibia with segmental defect larger than 4 cm after wide debridement were selected. The selected cases were categorized according to two groups; group 1 with preserved posterior cortex in the segmental defect site -six cases, group 2 without posterior cortex- six cases. The results were compared by assessing the size of bone defect, the interval between wide debridement and bone reconstruction, bony union time, complications, and clinical results. Results: The mean length of bone defect of group 1 was 7.6 cm (range 4.3-11.0 cm) and that of group 2 was 6.4 cm (range 4.0-12.0 cm). The interval between wide debridement and bone reconstruction was 10.0 weeks (range 5-18 weeks) for group 1, and 12.1 weeks (range 0-24 weeks) for group 2. The time for bony union of group 1 was 6.2 months (range 5-7 months), and that of group 2 was 10.8 months (range 7-18 months). In group 2, there were two cases of fatigue fracture and two cases of docking site nonunion after distraction osteogenesis. Conclusion: The preserved posterior cortex after wide debridement of infected nonunion of the tibia helps bony union and reduces the treatment period.