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폐쇄적 K강선 고정 및 관절 조영술을 이용한 소아 상완골 외과 골절의 치료
김용민,김경철,정필현,황정수,차응남,강석,안영언,박민효 대한골절학회 1995 대한골절학회지 Vol.8 No.1
Lateral condylar fracture of humerus is the secondly most common elbow injury in childhood. Compared to the most common supracondylar fracture which is fracture of metaphysis around olecranon fossa, lateral condylar fracture is intraarticular, epiphyseal injury and easily displaced by extensor muscle pull. Therefore, lateral condylar fractures are reduced and fixed more frequently by open method than supracondylar fractures are. In spite of affording more accurate reduction, however, open treatment of fracture can be complicated by infection, avascular necrosis, disfiguring scars, etc. So, it is more desirable that accurate reduction and rigid fixation can be achieved by closed method. Since July 1992, We manged 10 children with lateral condylar fractures of elbow using closed recuction, percutaneous K-wire fixation and intraoperative arthrogram for confirming the reduction status of articular margin. The fractures united and K-wires were removed within postop. 7 weeks(mean) in all cases. The patients were followed up for from 9 months to 2 years and 2 months postoperatively, revealed no great differences in carrying angle, range of motion and physical activity compared with contralateral elbow. Radiologic evaluation showed no definite complications except mild spur formation. Closed reduction and fixation followed by intraoperative arthrogram seemed to be one of the very useful method in the management of lateral humeral condylar fractures in children, especially in mildly displaced CRSCS.
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골반부의 둔상후 발생한 지연성 장골근내 혈종 - 증례 보고 -
김용민,정필현,황정수,강석,오형호,박민효,조윤철 대한골절학회 1995 대한골절학회지 Vol.8 No.3
Intramuscular hematoma in inner pelvic wall may not be a common problem for orthopaedic surgeons. It may be associated with fractures of pelvic bone, or bleeding tendency from various reasons Usually these hematomae are managed conservatively because they have no harmful effect to the patient, their position makes it difficult to approach. Furthermore, the diagnosis of the hematomae is not simple, so suspicion is important for its diagnosis. We experienced one case of delayed intramuscular hematoma in iliacus muscle in a 16-year old boy who had suffered blunt trauma to the pelvic area five weeks before. MRI had a signiticant role in the diagnosis of the hematoma. After evacuation of the hematoma, the patient recovered to normal status. Concerning about its unusual course and diagnostic significances of MRI, we report this case after reviewing of the literatures.
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확대 외측 도달법을 이용한 관절내 종골 골절의 수술적 치료
김지홍,김용민,정필현,황정수,강석,채동주,오형호,박민효,조윤철 대한골절학회 1996 대한골절학회지 Vol.9 No.3
Fractures with displaced articular facet of subtalar joint occupies 60-75% of whole calcaneal fractures. Nowadays, general principle of treatment far displaced intraarticular fracture has become anatomical reduction of joint surface and rigid fixation of the fracture. However, it had been difficult to apply this principle in cases of calcaneus due to various obsles such as anatomical characteristics, therefore outcomes were not satisfactory in many cases. Extended lateral approach, which was designed by Letournel and Benirschke, contributed greatly in overcoming those obstacles. From August 1992 to April 1994, the author managed fifteen displaced intraarticular fractures of the calcaneus in fourteen patients with open reduction of displaced intraarticular fragment via extended lateral approach and internal fixation using reconstruction plate. Thc fractures were examined pre- operatively with Broden's view and classified according to Eastwood(1992) with 2-plane CT. All the fractures united within postoperative 20 weeks(average l0.9 weeks). Final results were assessed by the clinical criteria for calcaneal fracture designed in Greighton Nebraska Health Foundation. Among the 15 cases, excellent results were obtained in eight cases, good in six, fair in one. There were no remarkable complications at the latest follow-up. In managing displaced intraarticular fractures of calcaneus, open reduction of displaced intraarticular fragment via extended lateral approach and internal fixation using reconstruction plate seemed to be very useful and harmless method.
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이수용,전대근,이종석,김석준,조경자,오형호,박민효,박현수,장진대,Lee, Soo-Yong,Jeon, Dae-Geun,Lee, Jong-Seok,Kim, Sug-Jun,Cho, Kyung-Ja,Oh, Hyung-Ho,Park, Min-Hyo,Park, Hyun-Soo,Jang, Jin-Dae 대한근골격종양학회 1996 대한골관절종양학회지 Vol.2 No.1
From January 1994 to August 1995 we performed 270 cases of fine needle aspiration cytology for bone and soft tissue lesions. Among them 137 cases were diagnosed histologically. Sixty-seven cases were benign and 70 cases were malignant. We analysed these on the aspect of sensitivity, specifity, positive predictive value, negative predictive value of the cytologic examination. Malignant cases consisted of bone tumor 29 cases; soft tissue tumor 25 cases; and metastatic tumor 16 cases. The sensitivity and specifity of the aspiration cytology for malignant tumor were 67.8% and 97%, respectively. The positive and negative predictive value of aspiration cytology were 97.4% and 72.7%, respectively. Among them 40 cases were primary bony lesions; 14 benign lesions, 26 malignamt bone tumors. Sensitivity of aspiration cytology for these primary bony lesion was 90%(18/20) and its specifity was 100%(13/13). Three cases showed atypical cells in cytology but with biopsy we could find them as one benign and two malignancies. Two cases of manignancy showed negative result in cytology; one was parosteal sarcoma of proximal femur and the other was osteosarcoma of proximal tibia which was biopsied already at other hospital. Although the overall sensitivity and specifity for malignant bone and soft tissue tumors were relatively low and not so predictable, the fine needle aspiration cytology for primary bony lesion was useful in the differential diagnosis of benign or malignancy.
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