60세 이상의 고령의 환자에서의 무시멘트형 고관절 전치환술의 결과 -최소 4년 이상의 추시 결과-

한창동 ( Chang Dong Han ),송계욱 ( Kye Wook Song ) 대한고관절학회 1996 Hip and Pelvis Vol.8 No.2

We performed 81 cases of cementless total hip replacement in patients, who were older than 60 years old at the time of operation from December 1986 to December 1991 and analysed 25 cases of them which were followed for minimum four years to evaluate the results of cementless total hip replacement in old age group over 60 years old. The average age of the patients was 66 years(60-80 years) at the time of operation, and the mean follow-up period was 58 months(48-83months). Nine cases were diagnosed with avascular necrosis, nine cases were fractures of neck of femur, five cases were osteoarthritis, one case was revision after hemiarthroplasty, and one case was ankylosed hip. The mean initial Harris hip scores was 42 and the mean final hip scores was 90. On radiologic evaluation, bone ingrowth(spot weld) was observed in 20 femoral component(80%), mainly junction of Gruen zone I and II, and VI and VII of porous coating area. The radiolucent line around the femoral component was observed in 23 cases(92%), mainly Gruen Zone I and IV, but it was thinner than 2mm and there was no thigh pain, no subsidence or migration of stem, and no progressive widening of line except three cases. Among those three cases, one case showed clinical and radiologic loosening of femoral component, so we performed revision total hip replacement. And other two cases are under close observation. No loosening was observed in acetabular components. The cementless total hip replacement in patients older than sixty years showed satisfactory results despite of poor bone quality and osteoporosis.

제5 중수골 경부 골절의 보존적 치료와 수술적 치료 결과의 비교

강호정(Ho Jung Kang),송계욱(Kye Wook Song),박관규(Kwan Kyu Park),성승용(Seung Yong Sung),한수봉(Soo Bong Hahn) 대한정형외과학회 2004 대한정형외과학회지 Vol.39 No.2

목적: 각형성된 제5 중수골 경부 골절의 보존적 치료와 수술적 치료 결과, 합병증에 대한 비교 및 수술적 치료에 대한 적응증을 알아보고자 하였다. 대상 및 방법: 제5 중수골 경부 골절로 내원한 환자 43예를 대상으로 25예에서는 수술적 치료, 18예에서는 보존적 치료를 하여 두 군에 대한 방사선학적, 기능적 결과를 비교하였다. 결과: 수술적 치료를 받은 군(수술 전: 40.7°)과 보존적 치료를 받은 군(수술 전: 38.5°)모두 다 교정 직후 만족할 만한 결과 (수술군: 15.3°, 보존군: 24.1°)를 얻었으나, 최종 추시상의 교정된 각형성의 유지는 수술군이 보존적 치료군보다 더 우수한 결과(수술군: 15.7°, 보존군: 34.2°)를 나타내었으며, 환자들의 주관적인 만족도도 높았다. 보존적 치료를 받은 군(38.9%)에서 수술적 치료를 받은 군(4%)보다 중수골 두부의 함몰 변형이 더 많이 일어났다. 치료 방법에 상관 없이 수부의 기능적 결과는 우수하였다. 결론: 보존적 치료시에 골절부 각교정의 유지가 잘 되지 않았으며, 대부분의 수부 합병증은 40° 이상의 각형성 잔존시 발생하였다. 따라서 140° 이상의 각형성이 있는 제5 중수골 경부 골절에서는 수술적 치료가 우선적으로 고려되어야 할 것으로 사료된다. Purpose: To evaluate the clinical results between conservative and operative treatments and to give guidelines in the treatment of angulated fifth metacarpal neck fracture. Materials and Methods: The 43 cases of fifth metacarpal neck fracture (25 operative cases, 18 conservative case) were reviewed. The functional and radiologic results between two groups were evaluated. Results: Both the operative group (preop.: 41.9°) and the conservative group (preop.: 39.7°) showed satisfactory results (operative group: 15.3°, conservative group: 24.1°) immediately after the correction. The maintenance of angulation correction was superior in operative group (15.7°) than in conservative group (34.2°), and patients subjective satisfactions were superior in operative group too. Depressed knuckle on dorsum of hand was more frequently observed in conservative group (38.9%) than operative group (4%). Functional result in both groups was good. Conclusion: Because the correction of angulation was not maintained well in conservative group and a large portion of complications often occurred in cases of angulation more than 40°, operative treatment is needed in cases of angulation of fractured site more than 40° in the fifth metacarpal neck fracture.

무지를 제외한 수근중수간 관절의 골절 및 탈구

강호정(Ho-Jung Kang),윤성환(Sung-Hwan Yoon),송계욱(Kye-Wook Song),한수봉(Soo-Bong Hahn),강응식(Eung-Shick Kang) 대한정형외과학회 2002 대한정형외과학회지 Vol.37 No.4

두상골 외상의 진단과 치료

강호정(Ho-Jung Kang),임대의(Dae-Eui Lim),송계욱(Kye-Wook Song),한수봉(Soo-Bong Hahn),강응식(Eung-Sik Kang) 대한정형외과학회 2001 대한정형외과학회지 Vol.36 No.2

수부에 발생한 전이성 골종양

강응식(Eung Shick Kang),신규호(Kyoo-Ho Shin),송계욱(Kye Wook Song) 대한정형외과학회 1997 대한정형외과학회지 Vol.32 No.7

외상 후 발생한 상지의 가성 동맥류

강호정(Ho-Jung Kang),성창훈(Chang-Hun Sung),강응식(Eung-Shick Kang),한수봉(Soo-Bong Hahn),송계욱(Kye-Wook Song) 대한정형외과학회 2001 대한정형외과학회지 Vol.36 No.5

소아 상완골 내상과 골절의 수술적 치료

강호정,강응식,송계욱,천용민,박회완 대한골절학회 2001 대한골절학회지 Vol.14 No.4

Purpose: We investigated injury mechanism, clinical feature, treatment, and prognosis in fracture of medial epicondyle of humerus in children. Material and Method: From April 1997 to April 2000, 10 fractures of medial epicondyle of humerus treated by operative method and followed up for minimum 12 months were analyzed retrospectively. Results: The injury mechanism includes slip down with elbow outstretched in 8 case, throwing ball in one case, arm wrestling in other one case. Ulnar nerve symptom at the distal region of fracture site was noted in one case. 2 cases had elbow dislocation at the time of trauma. Fractured fragment displaced more than 5㎜ in 9 cases and fractured fragment incarcerated in elbow joint in one case. Open reduction and internal fixation was done with medial approach. The mean period of cast immobilization was 6 weeks postoperatively and after removal of cast, gentle exercise of range of motion was started. After operation and postoperative follow up, in all case except one, the full range of motion of elbow joint was recovered and there were no ulnar nerve symptom and valgus instability in affected elbow joint. Conclusion: The indication of operation for fracture of medial epicondyle of humerus is controversial, yet. We had done open reduction and internal fixation for medial epicondyle of humerus only in case of displacement of fractured fragment more than 5㎜ and incarceration in elbow joint after manual reduction, ulnar nerve symptom. In 90 percents of all case, the result was satisfactory.

소아 요골 경부 골절의 수술적 치료

강호정,한수봉,강응식,송계욱,전재훈 대한골절학회 2001 대한골절학회지 Vol.14 No.4

Objects: Radial neck fractures are uncommon in children, and most cases were treated by conservative treatment or manual reduction. But if proximal fragment is angulated more than 30 degrees, and displaced more than 30%, operative treatment is needed. Operative treatment is also needed in cases of closed reduction failure or in type 4 of Salter-Harris classification. If open reduction is not performed, limitation of motion, altered carrying angle and radiologic change occur. We retrospectively analyzed 12 patients who had operative treatment for radial neck fractures in children. Materials & Methods: From April 1996 to December 1998, 12 patients with radial head fracture, were admitted to our hospital and were treated by operation. The average age of 9 years and 6 months (range 5 years 11 months to 14 years). Falling down was most common cause of injury. Seven cases were treated by open reduction and 5 cases by closed reduction. On open reduction group, 3 cases were fixed by Kirschner wire and 4 cases fixed by mini-screw. On closed reduction group, 3 cases were reduced percutaneously using steinmann pin, 1 case reduced using curet, and 1 case was fixed with Kirschner wire. Results: Ten cases were evaluated as good or excellent by criteria for judging results of radial neck fracture by Tibone and Stortz. Three cases had complication of heterotopic ossification, two cases had complication of limitation of motion and one case had complication of pin loosening. Conclusion: The operative treatment for radial neck fracture in children, improved the results of physical examination and roentgenographic evaluation. So operative treatment is needed for radial neck fracture in children which are more than 30 degrees angulation, more than 30% displacement and with displaced epiphyseal plate injury.

WSI-titan 장치를 이용한 하부요추질환의 치료

김남현,이환모,이진우,송계욱 대한척추외과학회 1996 대한척추외과학회지 Vol.3 No.2

Introduction. the implants for spinal segmental instrumentation have been developed and changed many times since their birth. the WSI-titan system was developed under the aims of easy handing and providing stable fization with short instrumentation. Objectives. The purposes are to introduce new device for spinal segmental instrumentation, the WSI-titan system, and to study the biomechanical features of WSI-titan system. And we checked bone mineral density, preoperatively and somatosensory evoked potentials, intraoperatively, to lessen the complications of the transpedicular screw fixation in spine surgery, which resulted from osteoporosis and malposition of screws. Materials and methods. We operated 16 cases of lower lumbar spinal diseases with WSI-titan system from November 1994 to August 1995 and the clinical results were analysed. Results. Of the 16 cases, the mean age of the patients was 55 years old and three cases were male and 13 cases were female and average follow up periods was 16 months. Eight cases were diagnosed spinal stenosis and the levels of lesion were lumbar stenosis in six cases and lumbosacral stenosis in two cases. Eight cases were diagnosed spondylolisthesis, and among them, five cases were isthmic type and three cases were degenerative type, and anterior slippage occurred at L4 in four cases and at L5 in four cases. The extents of fusion area were one segment in seven cases, two segments in eight cases, and three segments in one case. The cases which were measured bone mineral density lwer than 0.75g/㎠(about-3 of young age in Z csore) were excluded. Preoperative somatosensory evoked potentials were all normal and no significant change in intraoperative somatosencory evoked potentials. Radiologic union was observed at six months of follow up in five cases, at nine months insix cases, at 12 months in four cases, and at 15 months in one case. The clinical results were excellent in seven cases, good in eight cases, and fair in one case. Conclusion. The segmental spinal instrumentation with WSI-titan system in treatment of lower lumbar spinal diseases was highly successful method with providing rigid stability, biocompatibility, and easy handling. And the measurement of preopoerative bone mineral density was useful in selection of patient for preventing from loosening of pedicular screws. And intraoperative somatosensory evoked potential was also useful in preventing from nerve damage at pedicular screw insertion.