대퇴 골두 무혈성괴사에서 양극성 고관절 반치환술

서유성(You Sung Suh),권중호(Joong Ho Kwon),임수재(Soo Jae Yim),김연일(Yon Il Kim),최창욱(Chang Uk Choi) 대한고관절학회 1999 Hip and Pelvis Vol.11 No.3

Purpose : To report the analysis of the clinical and radiological results of Bipolar endoprosthesis treatment in patients with avascular necrosis(AVN). Materials and Methods : During 5 years and 7 months from January 1, 1990 to July 31, 1995, Bipolar endoprosthesis treatments, utilizing cementless stem have been performed in patients with AVN. For this study, 25 patients were followed up for 2 years minimum and 9 years and 7 months maximum with the average of 5 years and 1 month. We retrospectively analyzed the clinical results of Harris hip scores, thigh pain, and inguinal pain. In order to provide the statistical foundation for the comparison of acetabular erosion, we used x-rays of the acetabular cartilage from the anteroposterior view that were taken postoperatively each year for 4 years. These pictures were compared with the x-ray picture of the anteroposterior view that was taken immediately after the operation. The thickness of the acetabular cartilages has been measured with a caliper ; we found more than 50% acetabular ero-sion in the area between the acetabulum and the artificial cup. In the cases with more than 50% ero-sion, We investigated the effects of age, disease, process of AVN, type of stem, size and duration of the metal cup after insertion, and the occupation of the patient to determine risk factors for the erosion. Results : After the operation, Harris hip score improved in overall from 46 to 80 points. We found 10 cases of inguinal pain(40%) and 4 cases of thigh pain(16%). Among 17 cases(67%) of more than 50% erosion, 7 cases(40%) had occurred within 1 year after the operation, 4 cases(24%) within 2 years, 4 cases(24%) within 3 years, and 2 cases(12%) within 4 years. Younger age group with relative-ly more active life style showed a faster progress of erosion(p=0.01). We also found that more acetabu-lar erosion occurred with more serious AVN(Ficat stage) ; 1 case(25%) out of 4 at the Ficat stage 2 and 16 cases(76%) out of 21 at Ficat stage 3. Conclusion : We found that the degree of acetabular erosion increases in patients with young age,serious AVN, and longer period after the metal cup insertion.

고령의 고관절 골절 환자의 수술 후 사망률 및 관련 인자

서유성(You-Sung Suh),김용범(Yong-Beom Kim),최형석(Hyung-Suk Choi),윤홍기(Hong-Kee Yoon),서기원(Gi-Won Seo),이병일(Byung-Ill Lee) 대한정형외과학회 2012 대한정형외과학회지 Vol.47 No.6

목적: 고령의 고관절 골절 환자의 사망률과 수술 후 사망률에 영향을 미치는 인자에 대해 알아보고자 하였다. 대상 및 방법: 2006년 3월부터 2009년 12월까지 65세 이상의 고관절 골절로 수술을 시행 받은 304명의 환자들 중 수술 후 1년 내 사망 여부 추적이 불가능했던 43명을 제외한 261명을 대상으로 하였다. 연령, 성별, 수술 방법, 골절의 유형, 마취 방법, 수술 전 기저 질환, 그리고 수상 후 수술까지의 경과시간을 조사하여 수술 후 1년 내 사망과 관련이 있는 인자들을 통계적으로 분석하였다. 결과: 고령의 고관절 골절 환자의 수술 후 1년 내 사망률은 10.7%였다. 수술 방법, 골절의 유형, 마취 방법은 수술 후 사망률과 관계가 없었으나 연령, 성별, 수술 전 기저 질환의 수, 수상 후 수술까지의 경과시간, 기저 질환 중의 치매는 고령의 고관절 골절 환자의 수술 후 사망률에 영향을 미치는 것으로 조사되었다. 결론: 고령의 고관절 골절 환자의 수술 후 사망률은 10.7%였으며, 고령의 고관절 골절 환자의 수술 후 사망률에 영향을 미치는 인자는 연령, 성별, 동반 기저 질환의 수, 수상 후 수술까지의 경과시간, 기저 질환 중의 치매였다. Purpose: The aim of this study was to determine the mortality and factors that are related to the mortality in elderly patients with hip fracture. Materials and Methods: Between March 2006 and December 2009, 304 patients who were 65 years or older underwent surgery for hip fracture. Among them, 261 patients were available and 43 patients excluded from this study, as they were unable to be evaluated for one year mortality. We analyzed the relationship between the postoperative mortality and the associated factors (age, gender, the type of operation, the type of fracture, method of anesthesia, comorbidity, operation delay). Results: The one year mortality rate for elderly patients with hip fracture was 10.7%. There was no relationships between the postoperative mortality and the type of operation, the type of fracture, and method of anesthesia. However, age, gender, the number of comorbidity, operation delay, and dementia of comorbidity were factors associated with the mortality rate for elderly patients with hip fracture. Conclusion: The one year mortality rate for elderly patients with hip fracture was 10.7%. Age, gender, the number of comorbidity, operation delay, and dementia of comorbidity were factors associated with the mortality rate in elderly patients with hip fracture.

무시멘트형 Metal-Backed Cup에서 발생한 Polyethylene Liner의 분리

서유성(You-Sung Suh),유재응(Jae-Eung Yoo),진소영(So-Young Jin),신병준(Byung-Joon Shin),김연일(Yeon-Il Kim),최창욱(Chang-Uk Choi) 대한정형외과학회 1994 대한정형외과학회지 Vol.29 No.4

불안정성 대퇴 전자간 골절에서 양극성 고관절 반치환술 시 대전자부 골편 고정 방법의 비교

서유성 ( You Sung Suh ),최상욱 ( Sang Wook Choi ),박종석 ( Jong Seok Park ),임수재 ( Soo Jae Yim ),신병준 ( Byung Joon Shin ) 대한고관절학회 2008 Hip and Pelvis Vol.20 No.2

목적: 양극성 고관절 반치환술로 대퇴 전자간 골절을 치료하는 경우, 대전자 골편을 고정하는 3가지 방법의 임상적 및 방사선학적 결과를 평가하고자 하였다. 대상 및 방법: 46예를 대상으로 하여, 고정 방법은 1군) 8자형 강선 결박술(18예), 2군) 원형 강선 결박술(23예), 3군) 인장 대 강선 결박술(11예)이였다. 강선의 파손과 골편의 전위 여부로 방사선학적 평가를 하였고, Merle d’Aubigne 기준에 따라 기능적 평가를 하였다. 결과: 골편 전위 발생율은 1 군 22.2%, 2 군 52.2%, 3군 9.1%로, 군 간 유의한 차이가 있었다(p=0.022). 강선 파손 발생율은 27.8%, 13.0%, 9.1%로 유의한 차이가 없었다. 1군 78.6%, 2군 82.4%, 3군 88.9%이 Merle d`Aubigne 기준의 양호 이상의 기능적 결과를 보였다. 결론: 대전자 골편을 고정하는데 인장 대 강선 결박술이 더 유용한 방법으로 사료된다. Purpose: To evaluate clinical and roentgenographic outcomes after bipolar hemiarthroplasty utilizing three different greater trochanteric fragment fixation methods for intertrochanteric fracture repair. Materials and Methods: Forty-six hips (Boyd-Griffin type II: 44, type IV: 2) that had undergone greater trochanteric fragment fixation through bipolar hemiarthroplasty were evaluated at a minimum of 1 year following surgery. The fixation groups were: 1) figure of 8 wiring (18 cases), 2) cerclage wiring (23 cases), and 3) tension band wiring (11 cases). The roentgenographic results were evaluated in terms of fragment migration and wire breakage. The functional results were evaluated according to the hip rating scale of Merle d`Aubigne. Results: The rate of fragment migration was 22.2% in group 1, 52.2% in group 2, and 9.1% in group 3, and there was a statistically significant difference among the groups (p=0.022). The rate of wire breakage was 27.8% in group 1, 13.0% in group 2, and 9.1% in group 3, but there was no statistically significant difference among the groups. According to the Merle d`Aubigne scale, 78.6% of the repairs in group 1, 82.4% of the repairs in group 2, and 88.9% of the repairs in group 3 were rated as excellent, very good, or good. Conclusion: The tension band wiring method is more useful than the figure of 8 and cerclage wiring methods for fixing the greater trochanteric fragment during bipolar hemiarthroplasty.

고관절 주변에 발생한 요독성 종양성 석회증

서유성 ( You Sung Suh ),최형석 ( Hyung Suk Choi ),천동일 ( Dong Il Chun ),최성우 ( Sung Woo Choi ),김용범 ( Yong Beom Kim ),장병웅 ( Byung Woong Chang ),서기원 ( Gi Won Seo ) 대한고관절학회 2014 Hip and Pelvis Vol.26 No.1

종양성 석회증은 고관절, 견관절, 주관절과 같은 큰 관절 주변의 연부조직에 칼슘염이 침착 되는 매우 드문 질환이다. 발생원인에 대하여는 아직까지 명확하게 밝혀진 바는 없으나 신장의 근위 세뇨관에서 인의 대사 장애가 원인이라는 가설이 있고, 만성 신질환이나 부갑상선 기능항진증과 같은 질환이 원인이 될 수도 있다. 혈액 투석을 하는 만성 신부전 환자에서 발생한 속발성 종양성 석회증, 이른바 요독성 종양성 석회증에 대해 수술적 절제술 후 결과에 대하여 보고한 예는 국내에서는 없는 실정이다. 저자들은 고관절부 주위 종괴를 주소로 내원한, 혈액 투석 중인 57세 여자 환자에서 단순 방사선, 자기공명영상 및 전산화단층 촬영상 요독성 종양성 석회증을 진단하고 절제술 후 추시하여 임상적으로 만족할 만한 결과를 얻었기에 문헌고찰과 함께 보고하고자 한다. The term tumoral calcinosis in used to describe the deposition of nodular calcareous masses in the soft tissue around large joints, such as the hips, shoulders, and elbows. Although the cause has not yet been clearly determined, according to the hypothesis, failure of phosphorus metabolism in the proximal tubule in kidney, chronic renal disease and hyperparathyroidism may cause tumoral calcinosis. No cases of tumoral calcinosis treated with surgical resection in chronic renal failure patients on hemodialysis, so called uremic tumoral calcinosis, have been reported in Korea. The authors experienced the case of a 57-year-old woman with chronic kidney disease on hemodialysis who presented with a mass around the hip. We made a diagnosis using plain radiographs, magnetic resonance imaging, and computed tomography of tumoral calcinosis, and treated the patient successfully with surgical resection. We report on a case of uremic tumoral calcinosis with a review of the literature.

골용해의 진단 및 치료

서유성 ( You Sung Suh ),원성훈 ( Sung Hun Won ) 대한고관절학회 2011 Hip and Pelvis Vol.23 No.4

Total hip replacement arthroplasty (THRA) is widely performed, and is a successful orthopedic treatment method. Osteolysis, which often happens after THRA, causes a chronic inflammation stage due to wear debris in the artificial articular surface, leading to bone loss or loosening of implants. Osteolysis eventually results in shortening the lifespan of the joint. Afterwards, many researchers reported on the basis of experiments with tissue cultivation that due to the influence of wear particles, the surrounding tissues of the implants as obtained during replacement and the surrounding cells of the implants are secreting enzymes, prostaglandin, cytokine, and the like that stimulate the formation of fibrous tissues or bone resorption by osteoclasts. At this time, THRA was a main cement fixation method, so researchers thought that the loose particles of cement were the cause of osteolysis and aseptic loosening, and so they named these symptoms cement disease. However, despite the advancement of cement techniques and the use of cement-free implants, the osteolysis problem continued to rise, leading to polyethylene wear particles being regarded as the main cause of osteolysis, and naming these symptoms particle disease. In this way attention was drawn to new wear particles, now that it is revealed that ultra-high-molecular-weightpolyethylene (UHMWPE) or metal particles constitute the main cause. However, because no symptoms arise until serious bone defects or loosening occurs, it is difficult to diagnose or treat the disease early on. Thus, based on updated hypotheses and theories, this study examines the pathophysiology of osteolysis following THRA, as well as the diagnosis and treatment of osteolysis in the acetabular and femoral regions.

무 시멘트 대퇴 stem의 canal filling에 관한 임상적 고찰

서유성(You-Sung Suh),노영복(Young-Bock Know),신병준(Byung-Joon Shin),나수균(Soo-Kyun Rah),최창욱(Chang-Uk Choi) 대한정형외과학회 1994 대한정형외과학회지 Vol.29 No.3

Ilizarov 체외기기를 이용한 감염성 불유합의 치료

서유성(You Sung Suh),위요섭(Yo Sup Wee),나수균(Soo Kyoon Rah),최창욱(Chang Uk Choi) 대한정형외과학회 1994 대한정형외과학회지 Vol.29 No.3

고관절의 Lipoma Arborescens

서유성(You-Sung Suh),황재영(Jae-Young Hwang),이동화(Dong-Wha Lee),신병준(Byung-Jun Shin),나수균(Soo-Kyun Rah),최창욱(Chang-Uk Choi) 대한정형외과학회 1994 대한정형외과학회지 Vol.29 No.4

대퇴골 전자간 골절의 수술적 치료

서유성 ( You Sung Suh ),변인우 ( In Woo Byun ) 대한고관절학회 2007 Hip and Pelvis Vol.19 No.3