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견관절 재발성 탈구에서 관절경적 견관절 전방 고정술의 결과 : 2년에서 6년간의 추시 관찰 Two to Six-Year Follow-up
김승호,하권익,노규철,류병담,오일빈 대한스포츠의학회 2003 대한스포츠의학회지 Vol.21 No.1
The purposes of this study were to prospectively evaluate the surgical otucome of the arthroscopic repair of the capsulolabral lesion using suture anchors in al large series of patients who were followed-up for mid-term periods. We evaluated 167 patients with traumatic recurrent anterior shoulder instability after an arthroscopic Bankart repair using suture anchors and nonabsorbable sutures. The mean age at the time of the operation was 25 years (15~46 years). There were 149 male and 18 female patients. Preoperatively and at the time of follow-up(mean, 44 months; range, 24~75 months), three objective outcome measurement tools(Rowe Score, University of California at Los Angeles Shoulder rating scale, and American Shoulder and Elbow Surgeons score) and two subjective measurements(pain and function visual analogue scale) sere assessed. The recurrence rate, range-of-motion, and risk factor for postoperative recurrence were evaluated. All shoulder scores improved after surgery(t-test, p<0.05). According to the Rowe scale, One hundred and thirty patients(78%) showed excellent, 29(17%) good, 6(4%) fair, and 2(2%) poor scored. Overall, postoperative recurrence of the instability was 4%(1 dislocation, 2 subluxation, and 4 positive anterior apprehensions). Postoperative recurrence was related with the glenoid defect of greater than 30%(Gehan's test, p<0.0001). In patients with postoperative instability, the recurrent episode was less frequent and shoulder function was related with the activity were increased after the surgery(t-test, p<0.001). One hundred and fifty-two patients(91%) returned to more than 90%of previous activities. The mean loss of external rotation was 2.0±4.0℃. In contrast to the previous reports on the results of the arthroscopic repair, arthroscopic capsulolabral repair using suture anchors provided satisfactory outcomes in terms of the recurrence, activity, and range of motion.
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심종섭(Jong Sup Shim),진동규(Dong Kyu Jin),박승준(Seung Jun Park),김성민(Sung Min Kim),류병담(Byung Dam Ryu) 대한정형외과학회 2004 대한정형외과학회지 Vol.39 No.7
목적: 점액다당증 환자에서 구축된 관절의 임상 양상과 방사선학적 특징을 분석하여 보고하고자 한다. 대상 및 방법: 1996년 1월부터 2002년 3월까지 점액다당증으로 확진을 받은 환아 중, 골격계에 대한 방사선학적 검사와 충분한 이학적 관절 운동 범위 계측이 가능하였던 환아 15예를 대상으로 이학적 검진과 방사선 촬영, 기립상 전 척추 촬영, 그리고 골 연령 측정을 위한 수부촬영을 시행하였다. 결과: 견관절의 외전과 내회전 제한, 주관절의 굴곡 구축, 수근 관절의 수배굴곡 제한, 원위 지간 관절의 굴곡 구축, 고관절의 내회전 제한 등이 임상적으로 문제가 되었다. 척추 측만증은 모두 생리적 만곡 범위 내에 분포하였고, 상요추부의 후만 변형은 3예에서 경미하게 관찰되었다. 척추 변형으로 인한 신경학적 이상을 보이는 사례는 없었다. 골 연령은 지연 되어 있었으며, 역 연령이 증가할수록 골 연령의 지연은 증가하였다(Spearman's correlation coefficient=0.936, p<0.001). 결론: 관절 구축 및 관절 운동 장애는 상지에서 하지보다 심하였다. 척추의 변형은 비교적 경미하였고, 신경학적 증세는 발견되지 않았다. 골 연령의 지연은 나이가 들수록 증가되는 추세를 나타내었다. Purpose: To evaluate the clinical manifestations of contracted joints and the radiological features in mucopolysaccharidosis (MPS). Materials and Methods: From January 1996 to March 2002, 15 children from a pool of children diagnosed with MPS through a fibroblast culture and an enzyme assay, who could tolerate a large umber of examinations, underwent orthopedic physical and radiological examinations. Results: There were limitations in the abduction and internal rotation of the shoulder, extension limitation of the wrist, and internal rotation of the hip joint and flexion contractures of the elbow and DIP joints. Scoliotic deformities were all within the physiological curve. There were only three cases of a dorsolumbar kyphotic change and there were no neurological deficits due to the spinal deformities. The mean bone age was delayed compared with the mean chronological age. As the chronological age increased, the gap between the chronological age and the bone age increased. Conclusion: Joint contracture, which is the most severe symptom in orthopedic aspect, was more severe in the upper extremities than in the lower extremities. The spinal deformity was relatively mild and there were no neurological problems. The bone age tended to be delayed as the chronological age increased.
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