최소 절개 봉합술을 이용한 아킬레스건 파열의 치료 - 수술 방법 및 초기 결과 -

이근배,박유복,김병수,최진,정성택,Lee, Keun-Bae,Park, Yu-Bok,Kim, Byung-Soo,Choi, Jin,Jung, Sung-Taek 대한족부족관절학회 2006 대한족부족관절학회지 Vol.10 No.1

Purpose: To investigate the early results of limited open repair technique of Achilles tendon ruptures, and to describe the surgical technique. Materials and Methods: From October 2004 to February 2005, a total of 10 patients with Achilles tendon rupture underwent limited open repair. The average age of the patients was 39.3 years, and the average follow-up period was 9 months. The causes of injury were sports injuries in 8 cases, and slip down in 2. The mean interval between the injury and the operation was 9 days. The clinical results were assessed by patient's satisfaction, incision length, hospitalization, the ankle-hindfoot scale of American Foot and Ankle Society (AOFAS), and complications. Results: Of 10 patients, 8 were very satisfied, and the remaining 2 were satisfied. The mean incision length was 2.0 cm, and the mean hospitalization was 2 days. The mean AOFAS score was 97 points, and there was no complications such as infection, rerupture, or nerve injury. All patients returned to work at approximately 2 months, and resumed light exercise such as jogging at approximately 3 months. Conclusion: Limited open repair technique of Achilles tendon ruptures is provided for better cosmetic results, high patient's satisfaction, and functionally successful results without postoperative complications.

정상 한국 성인의 전족부에서 관찰되는 종자골과 부골의 종류 및 빈도

노성만,이근배,박유복,배봉현,강경도,Rowe, Sung-Man,Lee, Keun-Bae,Park, Yu-Bok,Bae, Bong-Hyun,Kang, Kyung-Do 대한족부족관절학회 2005 대한족부족관절학회지 Vol.9 No.1

Purpose: To determine the locations and incidences of sesamoids and accessory bones of the forefoot in normal Korean adults. Materials and Methods: The plain radiographs of the forefoot of 400 volunteers, 200 males and 200 females, were taken. The three orthopedic surgeons participated in the radiographic evaluation independently. Persons who had history of foot problem or injury were excluded. Results: Sesamoids of first metatarsophalangeal joint were nearly always present; medial 99% and lateral 100%. The bipartite sesamoid was more common in medial (9.8%) and in female (17.0%) than in lateral (0.3%) and in male (2.5%). Sesamoids of the interphalangeal joint of the first toe were seen in 35.8%. Sesamoids of metatarsophalangeal joints in other four toes were rarely observed. Their incidences were 5% in second toe, 0.8% in third, 0% in fourth, and 2.8% (lateral) and 7.5% (medial) in fifth. Sesamoids of interphalangeal joint in four lesser toes were not observed except two cases (0.5%) in the fifth toe. Accessory bone was very rarely observed. Os vesalianum was observed in five feet (1.3%), Os intermetatarseum in 14 feet (3.5%), and Os cuneo-metatarsal I tibiale in none. Conclusion: We determined the location and incidences of sesamoids and accessory bones of the forefoot, and we expected this to help to diagnose the forefoot problem.

후방 삽입구를 이용한 관절경적 거골하 관절 유합술- 수술 방법-

이근배,최진,박유복,서형연,서진수,Lee, Keun-Bae,Choi, Jin,Park, Yu-Bok,Seo, Hyeong-Yeon,Suh, Jin-Soo 대한족부족관절학회 2005 대한족부족관절학회지 Vol.9 No.2

A posterior 3-portal arthroscopic approach with the patient in the prone position provides a novel and optimal approach for isolated subtalar arthrodesis. This approach facilitates access to the posterior talocalcaneal facet and facilitates safe access with regard to the posteromedial neuromuscular bundle. The technique involves prone positioning, establishment of two posterolateral portals and one posteromedial portal, arthroscopic posterior talocalcaneal facet debridement, percutaneous morcellized bone grafting and internal screw fixation. Preliminary results have shown high patient satisfaction, an excellent fusion rate and less postoperative morbidity than open subtalar arthrodesis.

전족부의 방사선학적 관찰: 1982년과 2004년의 차이를 중심으로

노성만,이근배,박유복,김병수,김영진,Rowe, Sung-Man,Lee, Keun-Bae,Park, Yu-Bok,Kim, Byung-Soo,Kim, Yung-Jin 대한족부족관절학회 2005 대한족부족관절학회지 Vol.9 No.1

Purpose: We compared the bony arrangements of the forefoot in 2 different years, 1982 and 2004, to determine any changes with time period of 22 years. Materials and Methods: The radiographs of 200 normal Korean adults, 100 male and 100 female volunteers, were evaluated both in 1982 and 2004. The radiographic results were evaluated with as follows; hallux valgus angle (HVA), intermetatarsal angle (IMA), morphology of metatarsal head and relative anterior protrusion of the metatarsals and the phalanges. The mean ages were 38 years (23-52years) in 1982, and 37 years (24-50years) in 2004. Results: The mean of HVA decreased from 15.6 degrees in 1982 to 14.3 degrees in 2004 (p=0.047), and the mean of IMA increased from 8.0 degrees in 1982 to 9.4 degrees in 2004 (p=0.031). The morphology of metatarsal head and relative anterior protrusion of the metatarsals and the phalanges were not different between the two study years. Conclusion: Comparing with those of 1982 measurements, we found an increase of IMA and a decrease of HVA. A prospective study may be needed to illuminate course of the changes.

가골 신연술로 치료한 제 1 중족골 단축증

이근배,김병수,박유복,문은선,최진,Lee, Keun-Bae,Kim, Byung-Soo,Park, Yu-Bok,Moon, Eun-Sun,Choi, Jin 대한족부족관절학회 2005 대한족부족관절학회지 Vol.9 No.2

Purpose: To analyze the outcome of metatarsal lengthening of first brachymetatarsia by callotasis using an external fixator. Materials and Methods: Between January 1998 and February 2004, 10 patients (17 cases) were reviewed. The mean age at operation was 17.3 years. Seven patients had bilateral first brachymetatarsia and eight patients had combined 4th brachymetatarsia. The operations were performed with a monoexternal fixator, and distraction was started at a rate of 0.75 mm/day after 7 days. The radiographic results were evaluated by lengthening amount and percentage, fixation time, and healing index. Complications and AOFAS score were evaluated. Results: The average lengthening amount was 17.7 mm and the average lengthening percentage was 43.4%. The external fixation time was 107 days and average healing index was 69.8 days/cm. The evaluation according to AOFAS score was excellent in 12 cases and good in 5 cases. Complications were 4 cases of hallux valgus, 4 of metatarsophalangeal joint stiffness, 3 of medial angular deformity, 3 of pes cavus, 2 of pin breakage, 2 of pin site infection, and 1 of skin hyperpigmentation. Conclusion: Callotasis for 1st brachymetatarsia is a very useful treatment method with high patient satisfaction, excellent healing rate and early ambulation without bone graft. Nevertheless, great care must be taken to minimize the various possible complications.

Retraction: 후방 삽입구를 이용한 관절경적 거골하 관절 유합술 -수술 방법-

이근배,최진,박유복,서형연,서진수,Lee, Keun-Bae,Choi, Jin,Park, Yu-Bok,Seo, Hyeong-Yeon,Suh, Jin-Soo 대한족부족관절학회 2020 대한족부족관절학회지 Vol.24 No.4

국내외 흙 재료 분류기준 분석을 통한 개선방안 연구

오주한(Ju-Han Oh),최유복(Yu-Bok Choi),최원일(Won-Il Choi),임유진(Yu-Jin Lim),박시범(Si-Beom Park),이민수(Min-Soo Lee) 한국철도학회 2017 한국철도학회 학술발표대회논문집 Vol.2017 No.10

체외 충격파를 이용한 만성 근위부 족저 근막염의 치료

김병수,이근배,최진,박유복,백룡빈,Kim, Byung-Soo,Lee, Keun-Bae,Choi, Jin,Park, Yu-Bok,Baik, Long-Bin 대한족부족관절학회 2006 대한족부족관절학회지 Vol.10 No.2

Purpose: To evaluate the results of extracorporeal shock wave therapy (ESWT) for patients with chronic proximal plantar fascitis. Materials and Methods: Between April 2005 and April 2006, 35 cases (24 patients) who were followed more than 6 months were evaluated. By $EvoTron^{(R)}$, 2 sessions of ESWT (Group 1: 1200 and Group 2: 1500 shock waves / session of $0.12\;mJ/mm^2$) were performed at 2 weeks interval. The mean age was 40.0 (range, 15-59) years. 13 patients were male and 11 patients were female. Visual analogue scale (VAS) on daily activity and a 100-point scoring system including 70 points for pain and 30 points for function were used. The clinical outcomes were rated as follows: excellent, no pain on daily activity; good, less than 50% of previous VAS; fair, 50-75% of previous VAS; or poor, more than 75% of previous VAS. Excellent and good were graded as satisfactory results. We compare clinical results between groups and evaluate the relationships between clinical results and duration of symptom, fascial thickening and previous steroid injection were evaluated. Results: Overall satisfactory rate were 71.4%. There was no significant difference of clinical results between groups. And there were no significant difference between clinical results and duration of symtom, preoperative fascial thickening and previous steroid injection. Conclusions: ESWT for recalcitrant chronic proximal plantar fascitis is useful treatment method with high patient satisfaction and pain relief, but more long-term study must be needed.

양성 골 병변으로 인한 대퇴골 근위부 병적 골절의 치료

정성택(Sung-Taek Jung),박유복(Yu-Bok Park),조상권(Sang-Gwon Cho),임근영(Keun-Young Lim) 대한정형외과학회 2006 대한정형외과학회지 Vol.41 No.3

서론: 양성 골 병변으로 인한 대퇴골 근위부 골절의 치료 결과를 평가하였다. 대상 및 방법: 1987년 2월부터 2002년 7월까지 양성 골 병변으로 인한 대퇴골 근위부 골절로 치료 받은 19명, 23예를 대상으로 하였다. 양성 골 병변은 섬유성 이형성증 15예, 단순 골낭종 3예, 동맥류성 골낭종 2예, 거대 세포종 2예 및 호산구성 육아종 1예였다. 양성 골 병변에 대한 치료는 골 소파술과 고속 드릴(high speed burr)을 이용한 보조 치료 후 자가골 이식술을 1예, 동종골 이식술을 6예 및 동종골과 자가골 이식술을 3예에서 시행하였다. 최종 골절 치료 방법은 내고정술 18예(골수강 내 금속정 10예, 압박성 고 나사 6예, 금속판 1예, 나사못 1예), 석고 고정 3예, 인공 고관절 전치환술 2예였다. 결과: 골소파술과 골이식술을 시행한 10예 모두에서 재발은 없었다. 석고 고정을 시행한 3예 중 2예에서 대퇴골 근위부의 내반 변형을 보였으며, 최종 골절 치료로써 골수강내 금속정을 이용한 내고정술을 시행한 10예에서 재골절과 변형을 방지할 수 있었다. 결론: 다발성 섬유성 골이형성증인 경우 골수강 내 금속정을 이용한 내고정술이 골절 치료, 변형 교정 및 예방에 효과적이며, 고립성 양성 골 병변인 경우 철저한 소파술, 골이식술 및 내고정술이 병변 치료 및 재발 방지에 효과적이다. Purpose: The treatment results for a proximal femur fracture caused by a benign bone lesion were evaluated. Materials and Methods: Nineteen patients (23 cases) who had been treated for proximal femur pathologic fracture from 1987 to 2002 were enrolled in this study. The mean follow-up duration was 40 months. The causes and treatments of the pathologic fractures and complications such as nonunion, deformity and recurrence were evaluated. Results: The benign bone lesions treated were fibrous dysplasia (15), simple bone cyst (3), aneurysmal bone cyst (2), giant cell tumor (2) and eosinophilic granuloma (1). An autograft (3), allograft (2), and both autograft and allograft (3) was performed after adjuvant curettage with a high-speed burr. There was no recurrence in these 8 cases. At the final course, internal fixation was performed in 18 cases (intramedullary nail (10), compressive hip screw (6), plate (1), screw (1)), a hip spica cast 3 cases and a THR 2 cases. Three cases where a hip spica cast had been performed showed a varus deformity. A refracture and deformity were prevented in 10 cases who underwent intra-medullary nailing. Conclusion: The IM nail is very effective in preventing complications such as a deformity, refracture after a treatment for polyostotic fibrous dysplasia. However, in a solitary benign bone lesion, bone graft and internal fixation is effective after thorough curettage.

Hip Fracture in the Elderly Aged 80 Years and More

Sung-Man Rowe(노성만),Taek-Rim Yoon(윤택림),Jun-Yub Lee(이준엽),Yu-Bok Park(박유복),Bong-Hyun Bae(배봉현),Young-Jin Kim(김영진) 대한정형외과학회 2005 대한정형외과학회지 Vol.40 No.8

목적: 80세 이상의 노인에서 고관절 골절의 발생률과 골절 후 활동력 및 사망률에 대해 알아보고자 하였다. 대상 및 방법: 광주광역시와 전라남도에서 2001년에 발생한 고관절 골절에 대하여 역학적 조사를 하였다. 환자의 일차정보는 건강보험 심사평가원에 등록된 환자를 대상으로 하였으며, 이들을 대상지역의 정형외과 병ㆍ의원의 등록환자와 비교 검토하였다. 결과: 2001년에 80세 이상에서 341명의 환자에서 고관절 골절이 발생되었으며, 인구 10,000명당 63예(63/10,000)의 발생률을 보였다. 이러한 발생률은 백인종의 발생률보다는 낮았으며, 다른 아시아 국가의 발생률과는 비슷하였다. 341명을 대상으로 골절 후 사망률과 활동력에 대해 조사하였다. 150명(44%)이 침상 생활(grade Ⅳ)만 가능하였고, 66명(l9%)이 옥내생활(grade Ⅲ)이 가능하였으며, 125명(37%)이 골절 전과 동일하거나 약간 감소된 활동(grade Ⅰ, Ⅱ)이 가능하였다. 골절 후 1년 내 사망률은 26.1% (89사망/341명)였으며, 이는 일반 사망률의 2.1배였다. 결론: 골절 후 많은 환자에서(63%) 기능적 활동력을 회복하지 못하였으며, 사망률은 일반 사망률보다 2.1배 높았다. 또한 환자의 활동력 감소가 사망률 증가의 가장 중요한 인자이었다. Purpose: To determine the incidence, vitality (postinjury activity level), and mortality after a hip fracture in elderly patients aged 80 years and over. Materials and Methods: This study examined patients aged 80 years and over, living in Gwangju city and Jeonnam province, and who sustained a hip fracture during 2001. The primary patient information was obtained from the Health Insurance Review Agency (HIRA). As a crosscheck, all hospitals to which patients suspected of having a hip fracture might have been referred were visited. Results: A hip fracture occurred in 341 patients in this age group during 2001, with an incidence of 63 per 10,000 of the population (341/54,266). This incidence is lower than those reported in Caucasians, but is similar to that reported in other Asian countries. The postinjury activity levels were bedridden (grade Ⅳ) in 150 (44%), housebound with severe discomfort (Grade Ⅲ) in 66 (19%), and full or moderate activity similar to the preinjury level (Grade Ⅰ and Ⅱ) in 125 (37%). The one-year mortality rate of the fracture patients was 26.1 % (89 deaths/341 patients), which was 2.1 times higher than that of the general population (12.6%). Conclusion: Many patients (63%) did not achieve a high level of functional ability. The one-year mortality rate was 2.1 times higher than that of the general population, and level of activity had the most significant effect on the mortality rate.