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교합성 골수강내 금속정을 이용한 대퇴골 전자하 골절의 치료
고진홍,문도현,이범구,신영갑 대한골절학회 1997 대한골절학회지 Vol.10 No.3
Subtrochanteric fracture of the femur are difficult to treat successfully. Although performing operative treatment, the incidence of mechanical complication is higher than other sites of long bones. During the period of January. 1990 to June. 1995, twenty-four cases of subtrochanteric fracture of femur were treated by Interlocking intramedullary nail at the Department of Orthopedic Surgery, Gil Hospital, Incheon, and the results were obtained as follows: l. Associated injuries, which were common in lower limb(7 cases), pelvic bone(3 cases) and upper limb(4 cases) made a fracture more difficult to treat. 2. Fielding' s type 1E(12 cases) fracture and Seinsheimer's type II(18 cases) fracture and Russel-Taylor s Type IA(19 cases) fracture and Winqist-Hansen Type II (13 cases) fracture were most common. 3. The average union time was 19.3 weeks 4. The complications were three cases.: delayed union(1 case), infection(l cases), angular deformity(1 case). 5. Interlocking nail is one of the good implant for rigid fixation of subtrochanteric fracture, especially mechanical characteristics of interlocking nail have eliminated the requirement of surgically reconstituting the medial femoral cortex.
경골 Pilon 골절의 치료에 Ilizarov 술식의 적응과 유용성
고진홍,문도현,위성,이범구 대한골절학회 1997 대한골절학회지 Vol.10 No.4
A pilon fracture, which is defined as a comminuted intraarticular fracture of distal tibia, violates the articular region and the metaphysis with occasional extension into the diaphysis, and renders the bone difficult to restore to its anatomic shape. The best known treatment of the pilon fracture is, as recommended by A-0 group. In the treatments of the fractures with severe comminution or with significant open soft tissue injury aggressive tries for internal fixation with plate and screws in the distal tibia will result in inevitable stripping of the soft tissue and the periosteum. Therefore, dangers of the delayed union, nonunion, soft tissue necrosis and infection will be increased. The authors treated 14 cases by the Ilizarov external fixation technique for treatment of pilon fracture of the tibia. The average duration of external fixation was thirteen weeks. The results were as follows. l. Such techniques are especially useful in those injuries with extensive aricular communition and in the open pilon fracture with significant soft tissue compromise. 2. The average duration of external fixation was 13 weeks and the time to clinical union averaged 16A weeks. 3. In case of accurate reduction, the better clinical result was obtained.
황색인대 골화증에 의한 하반신마비 : 1례보고 A Case Report
고진홍,이수찬,이동호 대한척추외과학회 1994 대한척추외과학회지 Vol.1 No.2
Ossification of the ligamentum flavum(OLF) is a definite clinical entity and is thought to be a form of ectopic ossification which develops predominantly in the lower thoracic spine. OLF usually causes progressive compression myelopathy such as numbness and motor weakness in the lower extremities and difficulty in walking. The authors report a case of OLF at T9-10 and T10-11 associated with sudden paraplegia.
고령에서 대퇴골 전자간 골절 후 보행 능력 및 사망율에 대한 연구
박홍기,고진홍,문도현,이범구,고영규 대한골절학회 1997 대한골절학회지 Vol.10 No.4
Intertrochanteric fractures are common in older age group. But still many patients suffer from high morbidity and mortality and decreased ambulation levels, because of accompanying general weakness and various senile diseases. From January 1991 to February 1995, we treated 46 patients older than 65 years with intertrochanteric fractures of femur. A retrospective study was performed to determine which preand postinjury factors were predictive of mortality and ambulatory capacity 1 year after operation. Potential causative factors included age, gender, prefracture ambulatory ability, postoperative ambulatory ability, associated medical problem, fracture type, degree of osteoporosis, American Society of Anesthesiologists rating of operative risk, interval between injury and operation. This retrospective study were analyzed with following results; 1. Mortality was releated to prefracture ambulatory ability, postoperative ambulatory ability, ASA risk, interval between injury and operation, which were statistically significant 2. Eighteen(39%) patients maintained their prefracture ambulatory ability at a postinjury 1 year; Twenty-eight(61%) patients lost some degree of ambulatory ability.
불안정성 대퇴골 전자간 골절의 치료 : 후내측부 골편의 나사못 고정한 군과 고정하지 않은 군의 비교연구
김영성,고진홍,문도현,이범구 대한골절학회 1998 대한골절학회지 Vol.11 No.3
An unstable intertrochanteric fracture lacks continuity of the bone cortex on the opposing surfaces of the proximal and distal fragments. This cortical deficit is due to either comminution on the medial aspect of the neck(calcar- region) or a large and separate posterior trochanteric fragment. Treatment of unstable intertrochanteric fracture have taken method to restore bony contact medially and posteriorly by anatomical reduction or displacement osteotomy. The authors analyzed the 60 unstable intertrochanteric fractures treated by anatomic reduction and internal fixation with a compression hip screw from January 1990 to December 1995. We made a comparative analysis of the postero-medial fixation with additional screw(Group I ) and no fixation group(Group II ). We tried to find the difference of operation time, blood loss, union time, weight bearing time, neck-shaft angle, sliding length of lag screw and complication rate in two groups. The results were obtained as follows: 1. The mean union time was 1l.5 weeks in the Group I and 12.7 weeks in the Group II (p$gt; 0.05). 2. The mean weight bearing time was 6.1 weeks in the Group I and 8.3 weeks in the Group II (p $lt; 0.05). 3. The decrease of neck-shaft angle was 2.3 degree in the Group I and 5.2 degree in the Group II (p $lt; 0.05). 4. The sliding length of lag screw was 5.8mm in the group I and 11.2mm in the group II (p $lt; 0.05). 5. The lower complication rate was obtained in the group I than in the Group II, but two groups showed no significance by statistical analysis. In conclusion, the postero-medial fixation with additional screw in the treatment of unstable intertrochanteric fracture of the femur are suggested that medial cortical stability can be gained and early weight-bearing can be allowed.