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( Sueng Hwan Jo ),( Sang Hong Lee ),( Hyeon Jun Lee ) 대한고관절학회 2016 Hip and Pelvis Vol.28 No.1
Purpose: This study aims to determine the correlation between the fracture patterns and the complications in patients with femoral neck fracture treated with internal fixation. Materials and Methods: The study comprises 45 patients with femoral neck fracture treated with multiple screws or compression hip screw between May 2008 and April 2012. The mean age was 48 years at the time of the surgery and the mean duration from initial injury to surgery was 20 hours. The fracture patterns were identified according to the anatomical location, the Garden classification and the Pauwels classification. The occurrence of nonunion and avascular necrosis were reviewed with clinical results including Harris hip score and Lunceford hip function test. The correlation between the fracture pattern and occurrence of complications were analyzed. Results: Fracture site union was achieved in 40 hips with the average union time of 17 weeks. Five nonunions occurred which showed high likelihood to occur in subcapital type, displaced (Garden stage III or IV) and Pauwels type III fractures (P<0.05). Avascular necrosis was developed in 10 hips which was mostly in subcapital type and Pauwels type III fracture but no statistical significance was found (P>0.05). The mean Harris hip score was 91 points, and Lunceford functional results were excellent in 15 hips, good in 24, fair in 4 and poor in 2. Conclusion: There was high risk of nonunion in subcapital type fracture, displaced fracture (Garden stage III and IV) and vertically oriented fracture (Pauwels type III). Careful attention is needed in these fracture types.
Haglund씨 변형을 동반한 부착부 아킬레스 건병증의 수술적 치료 결과: 예비 보고
이준영(Jun-Young Lee),조승환(Sueng-Hwan Jo),양훈(Hoon Yang) 대한정형외과학회 2010 대한정형외과학회지 Vol.45 No.5
목적: 중심건 분할 도달법을 이용하여 수술한 Haglund씨 변형을 동반된 부착부 아킬레스 건병증 환자의 치료 결과를 보고하고자 한다. 대상 및 방법: 2007년 1월부터 2008년 12월까지 Haglund씨 변형을 동반한 부착부 아킬레스 건병증으로 수술적 치료를 받은 환자 중 l년 이상 추시가 가능하였던 11예를 대상으로 하였다. 평균 연령은 41.5 (21-62)세였으며 평균 추시기간은 16.3 (12-24)개월이었다. 전 예에서 중심 건 분할 도달법을 이용하여 후종골의 돌출부위 절제술 및 염증이 있는 점액낭의 제거술과 변성된 아킬레스건의 변연절제술을 시행 하였다. 방사선 족부 측면상에서 골 돌출부의 제거 정도를 평가하였으며, 수술 전후의 임상적 및 기능적 평가와 기타 합병증을 조사하였다. 결과: 전 예에서 술 후 골 돌출부가 완전히 제거되었으며 임상적 및 기능적 평가 모두 술 전에 비하여 개선되었다. 수술 부 하방에 경도의 저린 증상이 발생한 1예 외에 다른 합병증은 관찰되지 않았다. 결론: Haglund씨 변형을 동반한 부착부 아킬레스 건병증의 치료에 있어 건 분할 중심 도달법은 병변부를 이상적으로 노출시켜 병변을 효율적으로 치료할 수 있는 좋은 술식으로 생각된다. Purpose: We wanted to report on treatment outcomes in insertional Achilles tendinopathy patients with Haglund's deformity that were operated on using a central achilles tendon splitting approach. Materials and Methods: We enrolled six cases of insertional tendinopathy with concomitant Haglund's disease who underwent an operation between January, 2007 and November, 2008 and for whom follow-up duration for more than 1 year were available. The mean age was 41.5 (21-62) years; the mean follow-up period was 16.3 (12-24) months. Resection of retrocalcaneal bony prominences and inflamed bursa with debridement of degenerative tendons was done using central splitting approach in all cases. A lateral ankle radiograph was used to assess the amount of bony resection. Clinical and functional evaluations were done before and after the operation. Results: In all cases, retrocalcaneal bony prominences were completely resected. Clinical and functional outcomes were significantly improved. One case had a mild tingling distal to the operative lesion. There were no other complications. Conclusion: A central splitting approach is an efficient procedure that can provide sufficient exposure to remove pathologic lesions in patients with insertional Achilles tendinopathy accompanying Haglund's disease.
Ki Jun Kim,Haeng Cheol Lee,Ki Young Lee,Ji Young Kim,Sueng Teck Joo,Wyun Kon Park Korean Society of Critical Care Medicine 2002 Acute and Critical Care Vol.17 No.2
BACKGROUND: Naloxone,an opioidant agonist, has been s hown t o have a c ar di ovascular pressor effect in states of hemorrhagic and endotoxic shock.We determined the direct inotropic effect of naloxone using guinea pig right ventricular papillary muscles. METHODS: With institutional approval,isometric contractile force was measured in normal and 26mM K+ Tyrode's solution at various stimulation rates.Normal and slow action potentials (APs) were measured with conventional microelectrode technique.The effects of naloxone on sarcoplasmic recticulum function were evaluated by measuring rapid cooling contractures (RCCs)in normal Tyrode 's solution and rested-state (RS)contraction in low Na+ (25 mM)Tyrode's solution.Patch clamp study was performed to examine the direct effect on Ca2+ current in myocytes. RESULTS: Naloxone (50,100,200 micro M)caused dose-dependent depression of peak force and maximal rate of peak force (dF/dt-max)by 30,50 and 70%,respectively.Modest depression was shown in RS contraction in low Na+ Tyrode's solution.In 26 mM K+ Tyrode's solution,100 micro M naloxone markedly depressed late force development.100 micro M naloxone depressed RCCs by 20%. While 100 micro M naloxone did not alter amplitude or dV/dt-max in normal and slow APs at 0.25 Hz, AP duration was prolonged significantly.In patch clamp study,50 micro M naloxone depressed Ca2+ current by 50%. CONCLUSIONS: Naloxone depresses contractile force.Myocardial depressant effect partly seems to be caused by depressed Ca2+ influx through cardiac membrane.Rapid release of Ca2+ from the sarcoplasmic reticulum by depolarization and release by rapid cooling seems to be minimally affected.
관절 함몰형 종골 골절 환자의 최소 침습적 내고정술의 단기추시 결과
조승환 ( Sueng Hwan Jo ),이준영 ( Jun Young Lee ),하상호 ( Sang Ho Ha ),조성원 ( Sung Won Cho ),박상하 ( Sang Ha Park ) 대한골절학회 2013 대한골절학회지 Vol.26 No.2
목 적: 관절 함몰형 관절 내 종골 골절 환자에서 최소 침습적 내고정술을 시행하고 그 결과에 대하여 알아보고자 하였다. 대상 및 방법: 2008년 5월부터 2011년 5월까지 관절 함몰형 관절 내 종골 골절로 최소 절개 족근동 접근법을 이용한 술식을 시행은 환자 중 1년 이상 추시 가능하였던 17예를 대상으로 방사선학적 결과(B?hler angle, Gissane angle, calcaneal height-width, heel varus) 및 임상적 결과(American Orthopaedic Foot and Ankle Society [AOFAS] score, visual analog scale [VAS])를 평가하고 합병증 등을 조사하였다. 결 과: 술 후 방사선학적 평가상 B?hler 각은 7.9o에서 19.8o로 회복되었고 임상적 평가상 평균 AOFAS score는 82.45점 및 평균 VAS는 3.94로 양호한 결과를 보였다. 합병증은 표재성 감염 1예 및 거골하 관절염이 2예 발생하였다. 결 론: 관절 함몰형 관절 내 종골 골절에서 최소 침습적 내고정술은 방사선학적 및 임상적으로 비교적 만족스러운 결과를 보여 관적 정복술이 제한되는 경우 시도해볼 수 있는 수술법으로 판단된다. Purpose: To evaluate the short term follow-up results of minimally invasive technique in the management of Sanders type II,III, and IV joint depressive calcaneal fracture. Materials and Methods: Between May 2008 and May 2011, we studied 17 cases undergoing treatment with minimally invasive technique with modified sinus tarsi approach for Sanders II, III, and IV joint depressive intra-articular calcaneal fracture and were followed up for more than 1 year. We evaluated the treatment result by assessing the radiologic parameters (B?hler angle, Gissane angle, and calcaneal height/width/length) and clinical outcomes (American Orthopaedic Foot and Ankle Society [AOFAS] score and visual analog scale [VAS]) and investigating the complication. Results: Radiological results improved from 7.9o to 19.8o in the B?hler angle after the operation. Satisfactory results were obtained in clinical assessment with average AOFAS score of 82.45 and the average VAS score of 3.94. We experienced 3 cases of complications, 1 case of superficial wound infection and radiologic findings of subtalar arthritis in 2 cases. Conclusion: Minimally invasive technique may be a useful alternative surgical method in the management of Sanders type II, III, and IV joint depressive calcaneal fracture that cannot adopt extensile approach, which enable to obtain good radiological and clinical results.