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흉추와 요추부 방출성 골절의 후방 척추경 나사못 고정술 후 후만각도의 변화 -나사못 고정 범위에 따른 비교-
서정국 ( Jeong Gook Seo ),박종호 ( Jong Ho Park ),문정석 ( Jeong Seok Moon ),이우천 ( Woo Chun Lee ) 대한골절학회 2009 대한골절학회지 Vol.22 No.1
목적: 흉추와 요추부 방출성 골절에서 척추경 나사못을 이용한 후방 고정술 및 유합술 후 손상된 종판이 위치한 분절의 안정성과 나사못 고정 범위와의 관계를 확인하고자 하였다. 대상 및 방법: 흉추 또는 요추부 방출성 골절 환자에서 척추경 나사못을 이용한 후방 고정술 및 유합술을 시행한 후 6개월간 추시가 가능했던 41명의 환자를 대상으로 후향적 방법으로 연구하였다. 나사못 고정 범위에 따라 골절된 종판 방향으로 척추경 나사못을 1부위만 고정한 16명 (1부위 군)과 2부위를 고정한 25명 (2부위 군)의 두 그룹으로 나누어 수술 직후와 수술 후 6개월째 추시에서 측면 방사선상 후만 변형 각도를 측정하여 비교하였다. 결과: 1부위 군에서는 평균 17.5±2.4도 (범위: 7.2∼32.7도)의 후만 변형을 보였으나, 2부위 군에서는 평균 5.2±0.8도 (범위: 2.1∼7.4도)의 후만 변형을 보여 양 군 간 유의한 차이가 있었다 (p=0.000). 결론: 흉추와 요추부 방출성 골절에서 척추경 나사못을 이용한 후방 고정술 및 유합술을 시행하는 경우 술 후 후만 변형을 방지하기 위해서는 손상된 종판 방향으로 2부위의 나사못을 고정하는 것이 필요할 것으로 생각한다. Purpose: To evaluate the relationship between the level of screw fixation and the stability of the segment of endplate fracture after posterior pedicle screw instrumentation for thoracic and lumbar burst fractures. Materials and Methods: The 41 patients of burst fractures who had been operated with pedicle screw instrumentation were retrospectively evaluated. The patients were divided into two groups by the levels of screw fixation. One group was treated with screws fixed by one-level to the direction of fractured endplate (One-level group, 16 cases). The other group was treated with screws fixed by two-level to the direction of endplate fracture (Two-level group, 25 cases). The two groups were compared by the radiographic changes of kyphotic angle between the day of surgery and 6 months after surgery. Results: At the 6 months, one-level group showed the change of kyphotic angle of 17.5±2.4 degrees, which was different from two-level group of 5.2±0.8 degrees (p=0.000). Conclusion: In posterior pedicle screws fixation for thoracic and lumbar burst fractures, 2 vertebrae to the direction of the endplate fracture should be included to prevent the postoperative kyphotic change.
56세 남자의 제2 요추 압박 골절에서 수상 후 78시간에 나타난 위 음성 골 주사 검사
서정국 ( Jeong Gook Seo ),주해균 ( Hae Kyun Joo ),김성태 ( Sung Tae Kim ) 대한골절학회 2010 대한골절학회지 Vol.23 No.4
It is very rare that the bone scan after 72 hours from the trauma doesn`t exhibit the increased radio-nuclide uptake in the patient with fracture. The purpose of this study is to report the case that indicate the false negative finding in the bone scan performed after 78 hours from the trauma in the 56-year-old man with L2 compression fracture, including a review of the relevant literatures.
문정석,배우한,서정국,이우천,Moon, Jeong-Seok,Bae, Woo-Han,Seo, Jeong-Gook,Lee, Woo-Chun 대한족부족관절학회 2008 대한족부족관절학회지 Vol.12 No.2
Purpose: To determine the clinical and radiographic results of arthroereisis using the $Kalix^{(R)}$ implant (Newdeal, Lyon, France) for the treatment of flexible flatfoot deformity. Materials and Methods: From February 2005 to February 2007, we performed the subtalar arthroereisis on 8 patients (9 feet) of symptomatic flexible flat feet after more than 6 months of conservative treatment. Average age was 14.5 years ($11{\sim}29$ years) old. We checked the functional status with AOFAS functional score pre-operatively and at final follow-up. Radiologically, we took weight bearing anterior to posterior and lateral view of the feet, and measured the talo-first metatarsal angle, calcaneal pitch angle in pre-operatively and at final follow-up. Results: Mean follow up period was 34.4 months. Average AOFAS score improved from preoperatively 65.6 to postoperatively 94.8. Average lateral talo-first metatarsal angle reduced from $12.8^{\circ}$ preoperatively to $1.6^{\circ}$ at final follow-up. Average anterior to posterior talo-first metatarsal angle was reduced from $15.1^{\circ}$ preoperatively to $8.3^{\circ}$ at final follow-up. Average calcaneal pitch angle was increased from $9.5^{\circ}$ preoperatively to $12.0^{\circ}$ at final follow-up. Conclusions: Subtalar arthroereisis with Kalix$K^{(R)}$ implant can be considered to be one of treatment options symptomatic flatfoot deformity patients.
유연성 편평족에 대한 내측 전위 종골 절골술의 단기 추시 결과
박종호,문정석,이우천,배우한,서정국,Park, Jong-Ho,Moon, Jeong-Seok,Lee, Woo-Chun,Bae, Woo-Han,Seo, Jeong-Gook 대한족부족관절학회 2009 대한족부족관절학회지 Vol.13 No.2
Purpose: To evaluate the short-term results of medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot deformity. Materials and Methods: Twenty four patients (25 feet) who had undergone medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot between July 2004 and May 2007 were included. The mean age was 43.6 years (16~78 years). The mean follow-up was 26 months (14~50 months). Clinical outcomes were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS). Six radiographic parameters were measured from weightbearing radiographs to assess the difference between preoperative and postoperative radiographs. Results: The mean AOFAS score improved from 57.9 points preoperatively to 89.2 points at latest follow-up (p=0.000). The mean VAS improved from 62 points preoperatively to 23 points at latest follow-up (p=0.000). The mean talonavicular coverage angle on anteroposterior (AP) view changed from 20.2 degrees to 16.0 degrees (p=0.002). The mean calcaneal pitch angle on lateral view changed from 12.6 degrees preoperatively to 14.5 degrees at latest follow-up (p=0.001). Regarding these radiographic parameters, the difference between interobserver measurements was larger than that between pre- and post-operative measurements. The calcaneus was transferred medially by average 11.8 mm (p=0.003), which was 27.9% of the width of calcaneal tuberosity (p=0.000). The mean talo-first metatarsal angle on AP and lateral views, and navicular height on lateral view were not significantly changed. Conclusion: Medial displacement calcaneal osteotomy without flexor digitorum longus transfer for flexible flatfoot could lead to improve the clinical outcomes, although the restoration of medial longitudinal arch was not clinically significant.