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      • KCI등재

        족관절 외과의 점액낭염 절제술 후 발생한 활액막 누공의 수술적 치료: 증례 보고

        장효석,최홍준,Jang, Hyo-Seok,Choi, Hong-Joon 대한족부족관절학회 2015 대한족부족관절학회지 Vol.1 No.2

        Lateral malleolar bursitis of the ankle is a commonly encountered disease in the department of orthopedic surgery. Although most cases of lateral malleolar bursitis are managed by conservative treatments, operative treatment is considered in cases of infected bursitis or complication after surgery. There are several potential complications associated with operative treatment, including wound healing problem, skin necrosis, nerve injury, or recurrence. However, synovial fistula of the ankle as a complication after surgery for lateral malleolar bursitis has not been previously reported. The author experienced the complication of synovial fistula after surgery for lateral malleolar bursitis and obtained a satisfactory result in revision surgery for the complication, which was coverage of the fistular formation with a periosteal flap from the distal fibula.

      • 국가통합교통체계효율화법 개정에 따른 서울시 통행실태DB의 효율적 구축·운영방안 연구

        김순관 ( Soon Gwan Kim ),이신해 ( Shin Hae Lee ),권순실 ( Soon Sil Kwan ),장효석 ( Hyo Seok Jang ) 서울시정개발연구원 2010 연구보고서 Vol.2010 No.5

        To collect preliminary data for transportation planning and policy making in the rapidly changing transportation environment in the Seoul metropolitan area, two different surveys on travel behavior have been recently conducted: the Household Travel Survey within the capital region, which is a census on individual trips that has been conducted since 1996, and the Passenger Travel Survey between regions and in the metropolitan areas, which has been part of national transportation research since 1998. However, with the amendment of the National Transport System Efficiency Act and the release of the first Guidelines for the National Traffic Survey, a revision of methods and contents of existing surveys is required. Two types of surveys are planned to be done jointly, but there appears to be various obstacles such as differences in survey times and methods, or weak data links. This study analyzes the recently amended National Transport System Efficiency Act in order to come up with necessary actions and to figure out the difficulties in the National Passenger Origin-Destination (OD) Travel Survey, which is currently under development. Firstly, Choice-based Sampling has been suggested as a supplementary survey to the administrative sampling method. Secondly, as a means of increasing sample size, a supplementary OD survey for bicycles and freight has been proposed, Also, to make better use results of household travel surveys, it is recommended to develop an advanced modal index, to estimate public transit OD through transportation card data, and to improve passenger counting systems that include subway transfers.

      • KCI등재

        Modified Stoppa 접근법을 이용한 비구 천정부 감입 골편의 정복술 - 수술 술기 -

        김지완 ( Ji Wan Kim ),서용민 ( Yong Min Seo ),장효석 ( Hyo-seok Jang ) 대한골절학회 2017 대한골절학회지 Vol.30 No.3

        고령의 비구 골절에서는 대퇴 골두의 내측 전위로 인한 장사방형 표면 내측 전위 및 비구 체중 부하 천정부 감입 골절이 동반되는 경우가 흔한데 정복되지 않은 천정부 감입 골절은 퇴행성 관절염을 초래하여 나쁜 결과를 나타낸다. 저자들은 modified Stoppa 접근법을 통한 갑입 골절의 정복과 고정방법을 소개하고자 한다. In elderly acetabular fractures, central dislocation of the femoral head and impacted superior dome of the acetabulum is common. Unreduced dome impaction can lead to degenerative arthritis and results in poor results. Herein, we present a case of operative reduction and fixation performed via the modified Stoppa approach in acetabular fracture with superior dome impaction.

      • KCI등재

        견관절 불안정성 환자를 대상으로 한 부하 방사선 사진의 임상적 유용성에 대한 평가

        박진영(Jin-Young Park),김영복(Youngbok Kim),임화경(Hwa-Kyung Lim),문상원(Sang Won Moon),방진영(Jin-Young Bang),장효석(Hyo-Seok Jang) 대한정형외과학회 2016 대한정형외과학회지 Vol.51 No.4

        목적: 견관절 불안정성 환자에서 부하 방사선 사진의 임상적 유용성을 평가하였다. 대상 및 방법: 56명 환자와 20명 정상인에서 90도 외전과 0도 외회전에서 전후방으로(AER0/PER0), 외회전만 60도로 하여 전후방으로(AER60/PER60) 15 daN의 힘을 가하여 전위를 분석하고 신체검사법과 비교하였다. 결과: 환자군의 환측에서 모든 사진이 유의한 큰 전위를 보였고(p<0.05) AER60이 유의한 최소 전위를 보였으나(p<0.05) 건측에서는 특이 전위는 없었다(p=0.27). 정상인과의 비교에서 환측 PER0, PER60만 유의한 큰 전위를 보였다(p<0.05). 신체검사법은 16명의 전방 탈구 환자에서 마취하 anterior drawer test와 AER0가 양의 상관관계를 보였고(Spearman rho=0.56, p<0.024), 환자를 3 mm 전위를 기준으로 재구분하였을 때 load and shift test의 등급이 사진상의 전방 전위와(p=0.028), Kim’s test 양성 빈도가 후방전위와 상관성을 보였다(p=0.005). 결론: Telos GA-IIE 견관절 부하 방사선 사진은 건측과 환측을 구분할 수 있고 신체 검사법과 일부 상관성을 보였다. Purpose: The purpose of this study is to examine the clinical applicability of stress radiography in patients presenting with shoulder instability. Materials and Methods: Fifty-six patients diagnosed with shoulder instability and 20 healthy volunteers participated in the study. Degree of displacement of the humeral head as measured on stress radiography using a Telos GA-IIE device was compared with the results of the physical examinations. Four types of stress radiography were captured while applying 15 daN of force anteriorly (AER0 and AER60) and posteriorly (PER0 and PER60) at two different positions: (1) 90° of abduction combined with 0° of external rotation, and (2) 90° of abduction combined with 60° of external rotation. Results: The degree of displacement of affected shoulders of 44 patients showed significantly larger displacement than normal shoulders (p<0.05), and the comparison between 56 affected shoulders of the patients and 40 normal shoulders of the volunteers showed significantly larger displacement only in PER0 and PER60 of the patients (p<0.05). Among the four radiographs of affected shoulders, AER60 showed significantly less displacement (p=0.046). The anterior drawer test under anesthesia of 16 patients who underwent surgery for anterior instability showed positive correlation with AER0 (Spearman’s rho=0.56, p<0.024). Significantly larger anterior displacement of the load and shift test was observed in the subgroup with anterior displacement more than 3 mm (p=0.028), and higher positive frequency of the Kim’s test was observed in the subgroup with posterior displacement more than 3 mm (p=0.005). Conclusion: Stress radiography using a Telos GA-IIE device could discriminate the affected shoulder. Although it could not replace individual physical examinations, the degree of displacement correlates with some physical examinations for shoulder instability.

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