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이기행 ( Kee Haeng Lee ),김형민 ( Hyoung Min Kim ),김윤수 ( Youn Soo Kim ),정창훈 ( Chang Hoon Jeong ),박일중 ( Il Jung Park ),박일석 ( Ill Seok Park ),문찬웅 ( Chan Woong Moon ) 대한골절학회 2006 대한골절학회지 Vol.19 No.1
목적: 대퇴골 전자하 골절에 대하여 활강 압박 고나사를 이용한 관혈적 정복술 및 내고정술 후 치료 결과를 분석하고 그 유용성을 알아보고자 하였다. 대상 및 방법: 1997년 5월부터 2004년 6월까지 대퇴골 전자하 골절에 대해서 활강 압박 고나사를 이용한 내고정술을 시행 받고 12개월 이상 추시가 가능하였던 20예를 대상으로 하였다. 남자가 9예, 여자가 11예였으며, 평균 연령은 49.2세 (36∼80세)였다. Seinsheimer의 분류상 IIa형 1예, IIb형 4예, IIIa형 2예, IIIb형 2예, IV형 4예, V형 7예였다. 골유합 시기, 관절 운동범위, 보행상태 평가, 합병증의 발생 여부 등을 평가하고 분석하였다. 결과: 전 예에서 추가적인 수술적 치료 없이 골유합을 얻었으며 골유합 시기는 평균 19.8주 (16∼27주)였다. 최종 추시시 고관절과 슬관절의 심각한 관절 강직은 없었으며 17예 (85%)에서 술 전의 보행 상태를 회복하였다. 추시 중 내고정물 실패, 불유합, 부정유합, 심부 감염 등의 심각한 합병증은 없었다. 결론: 대퇴골 전자하 골절에서 활강 압박 고나사를 이용한 수술은 골수강 내 금속정의 삽입이 불가능할 정도의 협소한 골수강을 보인 경우, 근위 대퇴골의 변형이 있는 경우, 큰 나비형 골편을 갖는 분쇄 골절의 경우, 긴 나선상의 골절과 함께 내측의 피질골의 분쇄상을 보인 경우, 전자간 골절과 동반된 경우 등에 유용할 것으로 사료된다. Purpose: To evaluate the effectiveness of the compression hip screw, we reviewed the clinical results of cases of femoral subtrochanteric fracture which were treated with compression hip screw. Materials and Methods : From May 1997 to June 2004, 20 cases of femoral subtrochanteric fracture, which were treated with compression hip screw and followed up more than 12 months, were reviewed. By the Seinsheimer`s classification, there were 1 case of type IIa, 4 cases of type IIb, 2 cases of type IIIa and IIIb, 4 cases of type IV and 7 cases of V. We analyzed the treatment results by bony union time, range of motion, ambulation status and complications. Results: All 20 cases were gained bony union without serious complications and secondary operation. The average bony union time was 19.8 weeks. 17 of 20 cases were recovered pre-injury ambulatory status level. Conclusion: The compression hip screw may be effective in treatment of the femoral subtrochanteric fracture with very narrow intramedullary canal, proximal femoral deformity, comminuted fracture with large butterfly fragment, long spiral fracture with medial cortical comminution and combined intertrochanteric fracture.
이기행 ( Kee Haeng Lee ) 대한고관절학회 2009 Hip and Pelvis Vol.21 No.2
Hip pain is a common but nonspecific symptom that has many etiologies. Due to the complex anatomy of the hip and pelvis, locating the exact origin of pain may be difficult. Soft tissue diseases around the hip are relatively rare and their clinical symptoms are often nonspecific. For such patients, it is necessary to understand various hip diseases, and do proper history taking and examination to correctly diagnose and treat soft tissue diseases of the hip. Advances in imaging studies such as MRI and ultrasonography can provide accurate information on soft tissues. This article reviews the soft tissue diseases of the hip that are experienced by clinics. It may be helpful in the differential diagnosis of hip pain arising from soft tissue structures and in the treatment of such diseases.
대퇴골두 무혈성 괴사에 대한 혈관부착 비골 이식술 후 디지털 감산 혈관조영술 소견
이기행,김윤수,이해규,옥지훈,김배균,김형민,Lee, Kee-Haeng,Kim, Youn-Soo,Lee, Hae-Giu,Ok, Ji-Hoon,Kim, Bae-Kyun,Kim, Hyoung-Min 대한미세수술학회 2004 Archives of reconstructive microsurgery Vol.13 No.2
Purpose : To observe the patency of anastomosis site and the findings of circulation of grafted fibula in osteonecrosis of femoral head treated with vascularized fibular graft by use of digital subtraction angiography. Materials and Methods : 17 cases of 11 patients who underwent vascularized fibula graft for osteonecrosis of femoral head. We performed digital subtraction angiography(DSA) for them at second week postoperatively in 12 cases, at sixth week in 1 case, at sixth month in 2 cases, at twelfth month in 1 case, and eighteenth month in 1 case which had been got DSA at second week before. We observe the patency of pedicle, and the circulation of grafted fibula such as periosteal and intraosseous vessels with time. Results : All cases except one which were thought failure of selective angiogram showed good passage of blood flow through anstomosed pedicle on DSA. We found the differences in appearance of circulation of grafted fibula with time. DSA at 2nd and 6th week postoperatively revealed both of periosteal and intraosseous vessels along the fibula and blood pooling at the tip of fibula. DSA at 6th month showed maintenance of periosteal and intraosseous vessels along the fibula but did not clearly reveal blood pooling at the tip of fibula. The findings of DSA at 12th and 18th month were similar each other. The periosteal vessels were not seen as the grafted fibular bone were incorporated into surrounding femoral bone but intraosseous vessels were still seen. Conclusion : It was thought that DSA could be used for evaluation of the status of pedicle including anastomsed site and vessels of grafted fibula with time. The periosteal vessels of fibula were decreased with time but intraosseous vessels were still seen until 18th month after vascularized fibula graft.