외측 도달법을 이용한 관절내 종골 골절의 수술적 치료

고영도 ( Young Do Koh ),정훈 ( Hoon Jeong ),권영삼 ( Young Sam Kwon ) 대한외상학회 2005 大韓外傷學會誌 Vol.18 No.1

Purpose: We report the radiologic and the clinical results for surgical treatment of calcaneal fractures involving the subtalar joint. Methods: We evaluated the findings of radiographs and computed tomographs of 39 patients (40 cases) with intra-articular calcaneal fractures. The fractures were treated with open reduction via an extended lateral approach and internal fixation using a plate. We assessed the radiologic results, such as the Bohler angle, the Gissane angle, and the height/width ratio. We assessed the clinical results based on the critieria of Salama et al. Results: According to the Essex-Lopresti classification, 9 cases were classified as tongue type and 31 cases as joint depression type. According to the Sanders classification, 10 cases were classified as type IIA, 4 cases as IIB, 16 cases as IIIAB, 4 cases as IIIAC, and 6 cases as type IV. The mean preoperative Bohler angle was 7.7, the mean postoperative Bohler angle was 21.1, and the mean last follow-up Bohler angle was 16.8. Clinical results classified as 10 excellent, 13 good, 11 fair, and 6 poor. Conclusion: In the treatment of intra-articular fractures of the calcaneus, open reduction via an extended lateral approach seems to be a useful method in that it can provide direct exposure of the subtalar joint with little morbidity.

흰쥐에서 난소절제술후 투여한 에스트로젠이 골의 항산화 효소 활성에 미치는 영향

고영도(Young Do Koh),오세인(Se In Oh),이미숙(Mee Sook LEE),강창모(Chang-Mo Kang),곽충실(Chung Shil Kwak),성상철(Sang Cheol Seong),박상철(Sang Chul Park) 대한정형외과학회 1998 대한정형외과학회지 Vol.33 No.1

흉요추부 방출성 골절과 동반된 후방 인대군 손상의 진단에 사용된 자기 공명 영상의 유용성

고영도 ( Young Do Koh ),윤여헌 ( Yeo Heon Yun ),정훈 ( Hoon Jeong ) 대한골절학회 2003 대한골절학회지 Vol.16 No.4

골다공증성 척추 압박골절의 보존적 치료 시압박률 증가 양상 및 관련 인자

고영도 ( Young Do Koh ),박정수 ( Jeong Soo Park ) 대한골절학회 2015 대한골절학회지 Vol.28 No.2

Purpose: The purpose of this study is to determine the ideal period of brace application for thoracolumbar (T10-L2) osteoporotic vertebral compression fracture (OVCF) based on the progression of the vertebral compression with passage of time and to evaluate the factors associated with progression of thoracolumbar OVCF, when treated conservatively. Materials and Methods: This retrospective study included a total of 46 patients who were diagnosed with thoracolumbar OVCF and could be followed-up for at least 6 months. In this study, the increase of compression rate and the mean slope of compression rate per weeks were compared between two periods (from diagnosed date to 8 weeks and from 8 weeks to 6 months), as the standard point. Age, bone mineral density (BMD), osteoporosis treatment after injury, diabetes mellitus (DM) as underlying disease were also compared between two groups (setting up 15% as standard point of increase of compression rate, <15% and ≥15%). Statistical analyses were performed using the paired t-test to assess the increase of compression rate and using the linear mixed model to assess the mean slope change. The relationships between the factors and progression of compression were analyzed using t-test, chi-square test, and logistic regression analysis. Results: The increase of compression rate was 13.03% and 1.97% in each period and the difference between those two periods was 11.06% (p=0.00). At 8 weeks of follow-up, the mean slope was reduced by 1.12 (p=0.00). No statistically significant difference in related factors was observed between two groups. Conclusion: Considering the increase of compression rate with passage of time, brace should be applied strictly for an initial 8 weeks. And age, BMD, osteoporosis treatment after injury, and DM as underlying disease are not predictors of progression of compression in vertebral fractures.

흉요추부의 굴곡-신연 손상에서 최소 분절 고정

고영도 ( Young Do Koh ),이정준 ( Jeong Joon Lee ),하종경 ( Jong Kyong Ha ) 대한골절학회 2005 대한골절학회지 Vol.18 No.4

골다공성 압박골절의 풍선 후만성형술 시 추체의 변형 교정에 영향을 미치는 인자

고영도 ( Young Do Koh ),윤종석 ( Jong Seok Yoon ),김성일 ( Sung Il Kim ) 대한골절학회 2008 대한골절학회지 Vol.21 No.1

목적: 골다공성 압박골절의 풍선 후만성형술 시 추체의 변형 교정에 영향을 미치는 인자를 알아보고자 한다. 대상 및 방법: 골다공성 압박골절로 내원한 환자 중 풍선 후만성형술을 시행한 25예를 대상으로 하였으며 술 전 측와위, 시술 시 복와위 자세, 풍선압력 주입 후, 풍선압력 제거 후, 골시멘트 주입 후의 각각의 단계에 대해 추체 압박 정도와 후만각의 변화에 대해 방사선학적 결과를 분석하였다. 결과: 최초 복와 시, 추체 후만각과 전방 및 중간 추체 높이는 의미 있는 회복을 보였으며, 풍선압력 주입 시 또한 추체 후만각과 전방 및 중간 추체 높이의 의미 있는 회복을 보였다. 풍선압력 제거 시, 전방 및 중간 추체 높이는 유의한 감소를 보였지만, 추체 후만각의 증가는 보이지 않았다. 추체 후방부위는 각 단계에 대해 의미 있는 변화는 보이지 않았다. 최초 복와위 자세에서 풍선압력 제거 후의 변화 정도는 추체의 후만각과 전방 및 중간 추체 높이 모두 유의한 변화는 보이지 않았다. 결론: 골다공성 압박골절에서 풍선 후만성형술 시행 시 추체의 높이와 후만변형은 풍선압력 주입에 의해 회복되나, 풍선압력 제거 시 감소 소견을 보여 최초 복와위 시에 비해 유의한 차이는 보이지 않았다. 따라서, 풍선 후만성형술 시 추체의 후만변형 교정에 가장 큰 영향을 미치는 요소는 복와위 자세에 따른 골절 정복이라고 생각한다. Purpose: To study which factors affect the deformity correction of vertebral body during kyphoplasty procedure. Materials and Methods: 25 osteoporotic vertebral compression fractures were treated with balloon kyphoplasty from October 2006 to May 2007. Lateral radiographs were taken at 5 different stages with preoperative lateral decubitus position, after placing the patient in prone position on an operation table, after inflating balloon, after deflation and removal of the balloon, after inserting the cement. Then we analyzed the compression ratios and kyphotic angles of the vertebral bodies in each stage. Results: Placing the patient in prone position showed significant postural reduction in kyphotic angle and restorement of the anterior and middle body height. The inflation of the balloon demonstrated significant reduction of kyphotic angle and restorement of the anterior and middle body height. After the deflation, anterior and middle body height has decreased significantly. After the deflation, the kyphotic angle and the anterior and middle body heights were not restored signigicantly compared with those of initial prone position. Conclusion: Vertebral height and kyphotic angle were partially recovered by inflating the balloon, but the correction was lost after deflating the balloon. Statistically, the body deformity was not restored significantly after deflating the balloon compared with that of intraoperative prone position. Therefore, we concluded that, in kyphoplasty of osteoporotic compression fractures, the postural reduction is the most important factor in deformity correction of fractured vertebral bodies.

골다공증성 척추 압박 골절에서 풍선 척추 성형술 후 통증의 호전 및 관련 요인에 대한 분석

고영도 ( Young Do Koh ),김동진 ( Dong Jin Kim ) 대한외상학회 2014 大韓外傷學會誌 Vol.27 No.4

Purpose: The objectives of this study were to assess pain relief according to the time after kyphoplasty and to evaluate the factors affecting pain relief after kyphoplasty in the treatment of a single-level osteoporotic vertebral compression fracture. Methods: A retrospective review of 34 kyphoplasties for single-level osteoporotic vertebral compression fractures was performed. Pain relief was assessed by using the visual analogue scale (VAS) at preoperatively and postoperatively at 6 weeks, 3 months, and 6 months. Associated factors, including age, sex, pain duration, bone mineral density, and cement leakage, were evaluated using the patients’ medical records. Statistical analyses were conducted using the paired t-test to assess pain relief and using the independent t-test and Pearson’s correlation coefficient to evaluate the relationship between those factors and pain relief. Results: Preoperatively, the mean VAS score was 7.06. Postoperatively, it declined to 3.66 (p=0.001), 2.81 (p=0.001) and 2.24 (p=0.001) at 6 weeks, 3 months and 6 months, respectively. Also, statistically significant pain relief was observed during the periods from 6 weeks to 3 months (p=0.001) and from 3 months to 6 months (p=0.001). However, reduction of the VAS score showed no significant correlation with age, sex, pain duration, bone mineral density, or cement leakage (p>0.05). Conclusion: Our study suggests that a kyphoplasty may be effective in osteoporotic vertebral compression fracture patients with acute pain and that after the kyphoplasty, pain is reduced remarkably for 6 weeks and then continuously for 6 months. [ J Trauma Inj 2014; 27: 186-91 ]

추간판 질환과 감별을 요하는 복대동맥류

고영도(Young Do Koh),배서영(Su Young Bae),김동준(Dong Jun Kim),김종오(Jong Oh Kim),정형진(Hyung Jin Jung) 대한정형외과학회 2002 대한정형외과학회지 Vol.37 No.5

골다공증성 안정성 흉요추 골절 시 압박의 진행과 자기공명영상 소견의 상관관계

고영도 ( Young Do Koh ),윤종석 ( Jong Seok Yoon ),황지영 ( Ji Young Hwang ),박현식 ( Hyun Sik Park ) 대한골절학회 2008 대한골절학회지 Vol.21 No.4

제한 절개를 통한 관혈적 정복 및 내고정술을 이용한 경골 Pilon 골절의 치료

강충남,김종오,김동욱,고영도,고상훈,유재두,황준호,Kang, Chung-Nam,Kim, Jong-Oh,Kim, Dong-Wook,Koh, Young-Do,Ko, Sang-Hun,Yoo, Jae-Doo,Hwang, Jun-Ho 대한족부족관절학회 1997 대한족부족관절학회지 Vol.1 No.2

저자들은 1993년 9월부터 1996년 5월까지 본원 정형외과에 입원하여 Pilon 골절로 치료받고 1년 이상 추시 가능하였던 19례(18명)를 대상으로 다음과 같은 결론을 얻었다. 1. Ovadia와 Beals의 분류상 제1형이 2례, 제2형이 3례, 제3형이 10례, 제4형이 1례, 제5형이 3례였고, 제3형이 53%로 가장 많았으며, 교통사고와 추락손상 등 고에너지 손상에 의한 골절이 16례로 전체의 약 84%를 차지하였다. 2. 손상의 정도가 비교적 적은 제1형과 제2형에서는 모두 양호 이상의 임상결과를 나타내었으며, 제4형과 5형에서는 손상의 정도가 심하고 이로인한 정확한 정복의 어려움으로 인해 보통 이하의 성적을 나타내었다. 3. 합병증은 외상후 관절염이 6례로 가장 많았으며 손상정도가 심한 3형 이상에서 정확한 정복이 이루어지지 않은 경우에 발생하였으며, 방사선학적 평가가 보통이하였던 제3형 3례에서 부정 유합이 발생하였으나 임상결과와의 연관성은 없었다. 4. 저자들은 제한된 관혈적 정복 및 내고정술로 연부조직의 합병증을 현격히 줄일 수 있었으며, 손상의 정도가 적고 정확한 정복이 가능한 경우, Pilon 골절의 좋은 치료 술식의 하나라고 사료된다. The tibial Pilon fracture, which is defined as a comminuted intraarticular fracture of the distal tibia, is difficult to manage because high axial compression and rotational forces to the ankle joint result in impaction, severe comminution, metaphyseal disruption and soft tissue damage. There are variable methods of treatment such as manipulation and cast, calcaneal traction and cast, external fixation, pin and plaster, limited open reduction and external fixation, and open reduction and rigid internal fixation. Though most of authors reported better result after a surgical treatment. than that of conservative treatment, many complications such as posttraumatic arthritis and soft tissue problem still remain troublesome. We have reviewed 19 cases of the tibial Pilon fractures in 18 patients which were treated with limited open reduction and internal fixation from September 1993 to May 1996. The results were as follows: 1. The fractures were classified into five types according to the system of Ovadia and Beals, and the most frequent type was type 3 (53%). The most common cause of injury was traffic accident (47%). 2. All of the cases of type 1 and 2, in which the injury of the ankle joint was less severe, revealed good or excellent clinical results. But in type 4 and 5, because the injury is much severe and accurate reduction is difficult, the clinical results were unsatisfaetory. 3. The most frequent complication was posttraumatic osteoarthritis, and which developed in second frequent complication, was developed m the three cases of type 3 in which the radiographic results were less than fair, but there were no correlation with the clinical results. 4. We could markedly reduce the complications related to the soft tissue problem of Pilon fracture by treatment with limited open reduction and internal fixation, and consider that this is a good method of treatment of Pilon fracture when the injury is less severe and accurate reduction is possible.