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제5 중족골 기저부 제 I, II구역 비전위성 골절의 보존적 치료
성기선,고경환,구경효,박재철,Sung, Ki-Sun,Koh, Kyoung-Hwan,Koo, Kyung-Hyo,Park, Jae-Chul 대한족부족관절학회 2008 대한족부족관절학회지 Vol.12 No.2
Purpose: Zone I fractures of the fifth metatarsal bone can generally be treated by conservative methods while both surgical and conservative methods are used for zone II fractures. However, the clinical results of conservative treatment have been rarely reported. The purpose of this study is to report the clinical results of conservative treatment for zone I and II nondisplaced fractures. Materials and Methods: Between July 2007 and August 2008, consecutive thirty seven patients (38 fractures) with zone I and II fractures of the fifth metatarsal bone were treated with tolerable weight bearing and minimum duration of immobilization based on pain on weight bearing. We evaluated the duration of immobilization, time to clinical and radiographic union, and time to pre-injury activity level. Results: Clinical and radiological union were achieved in all patients without any complications including malunion or nonunion. The mean duration of immobilization was 28.7 days. The mean 33.1 days and 48.9 days were required for clinical union and radiographic union respectively, after the initial injury. The mean time to pre-injury activity level was 4.8 months. Conclusion: Our study shows that the acute nondisplaced zone I, II fracture of fifth metatarsal bone can be treated effectively using tolerable weight bearing and minimum duration of immobilization, which is based on the pain on weight bearing.
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가동형 삽입물 후방 십자 인대 보존형 슬관절 전치환술의 단기 추시 결과 -네비게이션을 이용한 술식-
문영완 ( Young Wan Moon ),서재곤 ( Jai Gon Seo ),임경섭 ( Kyung Sub Lim ),구경효 ( Kyung Hyo Koo ),김재균 ( Jae Gyoon Kim ) 대한슬관절학회 2009 대한슬관절학회지 Vol.21 No.3
목적: 네비게이션을 이용한 후방십자인대 보존형 가동형 폴리에틸렌 삽입물 슬관절 전치환술의 최소 3년 추시 임상적 결과 및 방사선학적 결과를 분석하고자 하였다. 대상 및 방법: 네비게이션을 이용한 후방십자인대 보존형 가동형 폴리에틸렌 삽입물 슬관절 전치환술을 시행 받은 54예(45명)를 대상으로 하였으며, 평균 연령은 65세(51∼76)이었고, 술 후 평균 추시 기간은 44(36∼61)개월이었다. 임상적 평가는 KSS와 관절 운동범위를 수술 전후로 비교하였다. 방사선학적 평가는 단순 방사선 사진을 이용하여 하지 정렬도와 삽입물의 위치에 대해 평가하였으며, 최종 추시상 합병증 여부에 대해서 분석하였다. 결과: 임상적 결과로 슬관절 점수는 38점에서 91점으로(p=0.001), 기능점수는 46점에서 92점으로 호전되었다(p=0.001). 운동범위는 108˚에서 123˚로 향상되었다(p=0.045). 방사선학적 결과로 관상면에서 98%에서 만족할 만한 방사선학적 결과를 보였다. 최종 추시상 방사선 투과선은 총 4예에서 나타났으나 임상적으로 의미있는 경우는 없었다. 결론: 연부 조직의 균형과 삽입물의 정확한 위치가 필수적인 후방 십자 인대 보존형 가동형 삽입물 슬관절 전치환술에 있어서 네비게이션을 이용하였을 때 정확한 술식이 가능하여 좋은 결과를 얻을 수 있는 방법이라 사료된다. Purpose: We wanted to report the minimum 3 year follow-up clinical results of the patients who underwent navigation guided cruciate retaining mobile bearing total knee arthroplasty and to evaluate the radiological results for a consecutive series of patients. Materials and Methods: Cruciate retaining mobile bearing total knee arthroplasties with using a navigation system were performed for 54 knees. The mean patient age was 65 years old (range: 51∼76 years). The mean follow up period was 44 months (range: 36∼61 months). The Knee Society Score (KSS) and range of motion (ROM) were evaluated for the preoperative and postoperative clinical assessments. We evaluated the alignment and the position of the implants by using plane radiographs for the radiological assessment, and we investigated the wear and loosening of implants in the same manner at the last follow-up exam. Results: The knee score improved from 38 to 91 (p=0.001) and the functional score improved from 46 to 92 (p=0.001). The mean range of motion was also improved postoperatively. The radiological results of the coronal axis alignment of the lower extremity and the implant position were satisfactory in 98% of the cases. Periprostheic osteolysis occurred in 4 cases, but there were no clinically significant osteolysis seen on the follow-up radiographs. Conclusion: Soft tissue balancing and the accuracy of implantation are necessary when performing cruciate retaining mobile bearing total knee arthroplasty. For this type of implant, navigation is useful tool to perform total knee arthorplasty for insuring the accuracy of the surgical procedure.
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