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외상성 주관절 변형과 동반된 지연성 척골 신경마비의 치료
이화성,김호태,송석환 대한골절학회 1998 대한골절학회지 Vol.11 No.2
Thirty-five patients with tardy ulnar nerve palsy caused by cubitus valgus (33 cases) and varus (2 cases) deformities were retrospectively studied. All patients had a history of old fracture on the distal humerus during childhood. The mean interval between the previous fractures and the onset of ulnar neuropathy was 19 years. The severity of nerve palsy was classified as McGowan's grade I in 24 patients, grade II in 8 patients, and grade III in 3 patient.. The mean carrying angle was average 29 degrees in 33 cases with cubitus valgus and it was decreased to average 11 degrees postoperatively, hut the angle was average -23 degrees preoperatively in 2 cases with cubitus varus and it was corrected to average 9 degrees postoperatively. The cause of palsy was analysed by mechanical stretching in 11 cases, compression by a fibrous band between the two heads of flexor carpi ulnaris in 8 cases, and diffuse fibrous adhesion around the ulnar tunnel in 5 cases, All patients was treated with supracondylar closing wedge osteotomy accompanied with anterior ulnar nerve transposition in l3 patients, corrective osteotomy only in 12 patients, and anterior ulnar nerve transposition only in 10 patients. Their end results were analysed as good in 24 cases, fair in 8 cases, and poor in 3 cases within average 6 months after the operations (4 to 13 months). The poor results was obtained in 3 cases out of 9 cases with corrective osteotomy group (33.3%). Conclusively, a tardy ulnar nerve palsy caused by post-traumatic elbow deformities should be corrected with anterior ulnar nerve transposition with or without corrective closing wedge osteotomy hut not by corrective osteotomy only, because of compressive neuropathy by diffuse fibrous adhesion or bands of two heads of FCU around the ulnar tunnel in elbow.
이화성,권순용,서은미,김용희,김성수 한국고분자학회 2011 Macromolecular Research Vol.19 No.1
Polymeric calcium phosphate cements (PCPCs) derived from biodegradable polyamino acids, such as polyaspartic acid (PAA) and poly-γ-glutamic acid (γ-PGA), were prepared in an attempt to improve their cohesion strength and injectability. The characteristics of the calcium phosphate cements (CPCs), such as dynamic viscosity, paste injectability, initial setting time, compressive strength and cell compatibility, were assessed. The dynamic viscosity increased significantly with γ-PGA incorporation but decreased with PAA incorporation. The injectability increased with the concentration of polyamino acids and that of the CPCs mixed with γ-PGA reached 94%. The initial setting time decreased with the γ-PGA concentration in the cement liquid and reached approximately 10-15 min when the γ-PGA concentration was 1-2 wt%. The compressive strength (CS) of CPCs after 1 week-incubation decreased with the incorporation of PAA and γ-PGA. γ-PGA incorporation deteriorated the CS more than PAA incorporation because the dissolution of alpha-tricalcium phosphate (α-TCP) was retarded. Saos-2 cells grown on CPCs with polyamino acids spread more than those grown on the CPC without them.
이화성,권순용,김동욱,정진화,Lee, Hwa-Sung,Kwon, Soon-Yong,Kim, Dong-Wook,Chung, Jin-Wha 대한족부족관절학회 2011 대한족부족관절학회지 Vol.15 No.4
Purpose: The aim of this study was to evaluate the result of combined Weil and dorsal closing wedge osteotomy for Freiberg's disease. Materials and Methods: We performed combined Weil and dorsal closing wedge osteotomy of the second metatarsal under the diagnosis of Freiberg's disease in 7 patients, 7 feet (2 male and 5 female). The mean age at the time of operation was 29 years and the mean follow-up period was 31 months. Patients had no trauma history and no combined deformity of the foot. The surgical results were evaluated by VAS and weight bearing radiographs in antero-posterior and oblique projection. Results: According to Smillie staging system, there were 1 of stage II, 2 of stage III and 4 of stage IV patients. The osteotomy site was united at 8 weeks and the second metatarsal was shortened in length of average 2.8 mm. Remodeling of the metatarsal head was observed at 24 months. The mean VAS was decreased from 8.2 points preoperatively to 2.7 points at follow-up. And average range of motion of second metatarso-phalangeal joint was increased from 30o preoperatively to 45o at follow-up. There was no transfer metatarsalgia or arthritis of the metatarsal head during follow-up. Conclusion: Combined Weil and dorsal closing wedge osteotomy of the metatarsal appears to be an effective procedure for the treatment of Freiberg's disease with a view to shortening of metatarsal length and elevation of metatarsal head.