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족관절 골절 수술에서의 유착방지제(Guardix<sup>®</sup>)의 효과 연구
김갑래,권환진,Kim, Gab Lae,Kwon, Hwan Jin 대한족부족관절학회 2017 대한족부족관절학회지 Vol.21 No.4
Purpose: Reducing tenderness or pain on the ankle joint and improving the range of motion are thought to be possible using hyaluronate-based anti-adhesive agents. On the other hand, there are more aspects to be studied regarding the incidence of complications, such as resting pain, tenderness, and stiffness, after surgery. Therefore, the aim of this study was to prove the effectiveness of the agents after ankle fracture surgery. Materials and Methods: Patients, who underwent open reduction and internal fixation surgery due to ankle joint fractures from June 2015 to May 2016, were studied prospectively. Thirty patients of them received a $Guardix^{(R)}$ injection during their surgeries and were included in the injection group. The other 30 patients were included in the control group. Postoperatively, tenderness on the scar, a delay in wound healing, and the active range of motion were evaluated at 2, 6, and 12 weeks after surgery. Results: A significant difference in tenderness on the scar was observed 2 weeks after surgery. On the other hand, there was no significant difference at 6 and 12 weeks after the surgery. The agent-using group showed a 6.7% delay in wound healing and a 93.3% nondelaying. In the non-using group, the delay was 63.3%, while non-delay was 36.7% (p<0.001). The group that underwent $Guardix^{(R)}$ usage showed an effective result in the visual analogue scale, which was statistically significant (p<0.001). The result at 6 and 12 weeks after surgery showed a significant difference. Conclusion: Improvement was observed in the patients who underwent a $Guardix^{(R)}$ injection, regarding the range of motion, visual analog scale, and healing of the wound postoperatively.
소건막류의 원위부 역위 사형 절골술 후 체중부하의 효과
김갑래,현윤석,신재혁,최상민,김권,박준식,Kim, Gab-Lae,Hyun, Yoonsuk,Shin, Jae-Hyuk,Choi, Sangmin,Kim, Kwon,Park, Junsik 대한족부족관절학회 2016 대한족부족관절학회지 Vol.20 No.4
Purpose: To evaluate the radiological and clinical effects of early weightbearing after distal reverse oblique osteotomy of bunionette. Materials and Methods: Between 2009 and 2015, 52 patients who underwent surgical treatment at our hospital for bunionette deformity with a minimum follow up of one year were included in the study. Postoperatively, foot cast was applied and full weightbearing was permitted in 28 patients. And short leg splint was applied with only partial weightbearing using crutches allowed in 24 patients. Clinical scores were evaluated. Radiologically, the 4th~5th intermetatarsal angle (IMA), and 5th metatarsophalangeal angle (MPA) were analyzed preoperatively and at the final follow up visit. Results: The visual analogue scale and American Orthopaedic Foot and Ankle Society scores improved in the partial weightbearing group and full weightbearing group, but without significant differences. The average 4th~5th IMA and average 5th MPA correction also did not showed significant differences between the partial weightbearing group and full weightbearing group. Moreover, the full weightbearing group did not encourage non-union rate compared with the partial weightbearing group. Conclusion: Effective bone union may be achieved through early weightbearing, resulting in better clinical outcomes. It is considered that early weightbearing did not have any effect on the changes of IMA and bone union.
김갑래,신성일,김태화,박현진,Kim, Gab-Lae,Shin, Sung-Il,Kim, Tae-Hwa,Park, Hyun-Jin 대한족부족관절학회 2009 대한족부족관절학회지 Vol.13 No.2
Heel abscesses present as heel pain that progressively worsens, with associated tenderness and fullness a the heel pad. To our knowledge, there are fews reports in the literature describing a spontaneous heel pad abscess. A 48-years old woman presented spontaneously with pain, erythema, edema and increased warmth to this right foot. She has no underlying disease and steroid injection history. A radiologic examination was suggestive of an abscess. Follow incision and drainage, cultures that were taken during the surgical procedure did not produce any organism. The patient was discharged home and recovered from the abscess without recurrence or further surgical intervention.
종골의 비골 결절 골절제술 후 발생한 장비골건 파열에 대한 수술적 치료: 증례 보고
이진영,김갑래,정민,이의수,권재우,서동연,Lee, Jin-Young,Kim, Gab-Lae,Jung, Min,Lee, Eui-Soo,Kwon, Jae-Woo,Seo, Dong-Yeon 대한족부족관절학회 2014 대한족부족관절학회지 Vol.18 No.2
We experienced a patient in whom rupture of the peroneus longus tendon occurred after ostectomy of the peroneus tubercle of the calcaneus. Acute rupture of the peroneus tendon can be managed by end-to-end anastomosis, while neglected cases can be treated by tenodesis, tendon transfer, or tendon graft. In the current patient, the tendon ends were mildly retracted, yielding a small gap. We successfully repaired the retracted tendon ends after lengthening by Z-plasty.
외측 족관절 불안정성 환자에서 봉합 나사와 PushLock Anchor를 이용한 변형 Brostrom 술식
신성일,김갑래,조주성,이효범,권재우,Shin, Sung-Il,Kim, Gab-Lae,Jo, Joo-Sung,Lee, Hyo-Bum,Kwon, Jae-Woo 대한족부족관절학회 2012 대한족부족관절학회지 Vol.16 No.4
Purpose: The purpose of our study was to perform a comparison of the outcomes of the modified Brostrom procedure using only a suture anchor compared with using a suture anchor with a pushlock anchor. Materials and Methods: This was a retrospective study of chronic lateral ankle instability that underwent a modified Brostrom procedure using a bioabsorbable suture anchor & a pushlock anchor, performed by a single surgeon. A total of 88 patients were enrolled in the study. The function of the patient's ankles were scored using the American Orthopaedic Foot and Ankle Society (AOFAS), visual analogue scale (VAS) both preoperatively and postoperatively. Results: The difference in the overall means between the group A and group B was not statistically significant. But, the patient's satisfaction was better in the group B, and there were more complications in the group A. Conclusion: The technique presented here uses the modified Brostrom procedure with pushlock anchors to prevent the problems associated with subcutaneous knot irritation.
당뇨발과 동반된 중증 허혈성 하지에서의 다각적 접근 방법의 치료
최현희,김갑래,이재희,이의수,Choi, Hyun-Hee,Kim, Gab-Lae,Lee, Jae-Hee,Lee, Eui-Soo 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.1
Purpose: The purpose of this study is to evaluate treatment results of multidisciplinary approach of critical ischemic limb with diabetic foot. Materials and Methods: From March 2005 to March 2012, 674 diabetic foot patients were analyzed. Among them, 85 patients were neuroarthropathic type, 383 patients were infectious type, and 206 patients were ischemic type. The subjects were 206 patients who had critical ischemic limbs and major or minor amputations were done. Various single or combined treatment method before amputation was performed. We investigated their ABI, HbA1c, main occlusion lesion, limb salvage and hospitalization period by various treatment method. Results: Major amputation was 27 cases, minor amputation was 179 cases. Mean HbA1c was 8.2%, and mean ABI was 0.66. Main occlusion lesion was 6 cases at common iliac artery, 13 cases at external iliac artery, 9 cases at internal iliac artery, 11 cases at common femoral artery, 23 cases at deep femoral artery, 52 cases at superficial femoral artery, 35 cases at popliteal artery, 40 cases at posterior tibia artery, 35 cases at anterior tibial artery, 28 cases at peroneal artery, and 13 cases at dorsalis pedis artery. Major amputations were decreased, minor amputations were increased, and hospitalization period was reduced by treatment of multidisciplinary approach. Conclusion: Treatment of multidisciplinary approach, which include preoperation percutaneus transluminal angioplasty, vascular surgery, and amputation, of critical ischemic limb with diabetic foot had advantages of limb salvage and hospitalization period reduction.
외상 후 발생한 비골 단축증의 수술적 치료: 증례 보고
김지연,김갑래,이채호,Kim, Jiyoun,Kim, Gab-Lae,Lee, Chae-Ho 대한족부족관절학회 2021 대한족부족관절학회지 Vol.25 No.4
Pediatric ankle fractures can cause physeal injuries which can lead to the shortening of the fibula. This induces a lateral shift of the talus, valgus tilt, and instability of the ankle joint, which can result in an arthritic change in this joint. Patients with a shortening of the fibula may complain of constant pain and restricted movements in their daily lives and during sports activities. Ankle reconstruction with fibula lengthening Z-osteotomy can provide excellent results if arthritis is absent or minimal, especially in young and active patients. To the best of the authors' knowledge, this is the first report in South Korea regarding the treatment of fibula shortening following a growth arrest due to injury.
거골하관절 불안정성이 족관절 불안정성을 치료하는 데 중요한 요소로 작용할까?
이효범,김갑래,김동현,Lee, Hyobeom,Kim, Gab-Lae,Kim, Donghyeon 대한족부족관절학회 2021 대한족부족관절학회지 Vol.25 No.1
Subtalar joint instability (STI) is one of the causes of persistent hindfoot pain even after treatment for ankle instability. Diagnosis of STI is often neglected because it is a poorly understood concept. However, understanding of the anatomy and injury mechanism of the subtalar joint is a prerequisite of appropriate treatment. Patients with STI usually complain of several symptoms, such as recurrent sprains or a giving way sensation and rolling over. Recently, various diagnostic tools and treatment methods have been investigated. This study was undertaken with the aim of helping clinicians by providing a comprehensive understanding of STI.
중족부에 발생한 다발성 악성 말초 신경초 종양 1예: 증례 보고
이효범,김갑래,김동현,Lee, Hyobeom,Kim, Gab-Lae,Kim, Donghyeon 대한족부족관절학회 2020 대한족부족관절학회지 Vol.24 No.4
Malignant peripheral nerve sheath tumors (MPNSTs) usually arise in soft tissues; they are rarely found in the bone. This paper reports a case of MPNST in the foot and ankle joint involving the distal tibia, talus, calcaneus, navicular, medial intermediate, and lateral cuneiform, cuboid, and 2nd to 4th metatarsal bone. Palliative treatment was performed. The authors encountered a patient with intraosseous MPNST of the midfoot who presented with nonspecific clinical and radiologic findings. This case shows that a high index of suspicion and a histopathology examination, including immunohistochemistry, will be necessary for an accurate diagnosis.
색소 융모 결절성 활액막염 제거 후 발생한 중족부 해면 혈관종(1예 보고)
송경원,김갑래,김태화,박현진,Song, Kyoung-Won,Kim, Gab-Lae,Kim, Tae-Hwa,Park, Hyun-Jin 대한족부족관절학회 2010 대한족부족관절학회지 Vol.14 No.1
Hemangioma are not rare tumors. They can be found in almost any of the vascular structures of the body. Hemangiomas involving the deep structures of the extremities may produce extremely difficult therapeutic problems for the orthopedic surgeon. Pigmented villonodular synovitis (PVNS) is a rare proliferative disorder that affects synovium, tendon sheath and bursa. Although the condition can present in any joint, knee joint is the most commonly affected site and only 2.5% of cases occur in foot and ankle joint. We have experienced a patient who has of foot and report an optimal method of surgical treatment. Authors report the result of hemangioma in mid-foot which arise from removal of a pigmented villonodular synovitis that has low out break rate of benign tumor in mid-foot with literature review.