진구성 전방 십자 인대 견열 골절의 수술적 치료

송은규,설종윤,최진,Song Eun-Kyoo,Seol Jong-Yoon,Choi Jin 대한관절경학회 2002 대한관절경학회지 Vol.6 No.1

Objective : The purpose of this study was to evaluate the clinical and radiological results after treatment of old ACL(anterior cruciate ligament) avulsion fracture of tibia. Materials and Method : 11 cases who were followed up at least 2 years after treatment in chronic ACL avulsion fracture of tibia were included in this study. The average age of patients was 26(9-66) years and the mean period of follow up was 53(24-131) months. After evaluation of the lesion and treatment of associated lesion under arthroscope, open reduction and internal fixation or fragment removal was performed. Pull-out suture was performed in 8 cases, screw fixation in 2 cases. Results : The Lysholm knee score was 64.3 in average preoperatively and improved to 96.2 average at follow up. On the Lachman test, there were mild(+) instabilities in 7 cases, moderate(++) in 4 cases. On the postoperative Lachman test, there were no instabilities in 9 cases, mild(+) instabilities in only 2 cases. According to Meyers and Mckeever's evaluation protocol, 9 cases $(81.8\%)$ were excellent, 2 case $(18.2\%)$, good. On preoperative instrumented anterior laxity test with $Telos^{\circledR}$, side to side difference in 201b was 7.8(10-4) min in average and 2.1(6-0) mm in average at follow-up. Conclusion : In chronic ACL avulsion fracture, it is thought that combination of arthroscopic evaluation of associated injury and open reduction and fixation and fragment removal can bring about satisfactory results.

자가 골-슬개건-골 및 슬괵건을 이용한 전십자인대 재건술후 결과 비교

송은규,이근배,서형연,설종윤,Song, Eun Kyoo,Lee, Keun Bae,Seo, Hyoung Yeon,Seol, Jong Yoon 대한관절경학회 1999 대한관절경학회지 Vol.3 No.2

Purpose : The purpose of this study is to compare the clinical and radiologic results of the anterior cruciate ligament(ACL) reconstruction using bone-patellar tendon-bone unit with doubled semitendinosus and gracilis tendons. Materias and Methods : Clinical results of ACL reconstructions which were performed in 47 patients using doubled semitendinosus and gracilis were compared with those performed in 45 patients using bone-patellar tendon-bone autograft. There were no differences in preoperative parameters(age, sex, instability). Average follow-up period were 17 months and 19 months each. Results : There were no significant differences between two groups in functional results (Lysholm knee score), degree of laxity and range of motion at final follow-up. However, the parapatellar complication, especially anterior knee pain after long distance walking or exercise and quadriceps weakness less occurred in hamstring tendon group than in bone-patellar tendon-bone group. Conclusion : Although there were no significant differences in clinical results of ACL reconstruction using bone-patellar tendon-bone autograft and doubled semitendinosus and gacilis, parapateller complications occurred more in the bone-patellar tendon-bone autograft group than in the doubled semitendinosus and gracilis group. It is thought that the careful selection of patient, achivement of skillful technique and active rehabilitation are important to prevent the parapatellar complications.

고관절 이형성증에서 Center Edge 각에 따른 응력분포와 비구회전 절골술의 생역학적 영향

윤택림(Taek Rim Yoon),노성만(Sung Man Rowe),설종윤(Jong Yoon Seol),조규종(Kyu Jong Cho),김규하(Gyu Ha Kim),반제삼(Je Sam Ban) 대한정형외과학회 2003 대한정형외과학회지 Vol.38 No.2

대퇴골 전자하 골절의 치료 - 내고정물에 따른 치유 효과 비교 -

윤택림(Taek Rim Yoon),노성만(Sung Man Rowe),송은규(Eun Kyoo Song),설종윤(Jong Yoon Seol),신상규(Shin Sang Gyoo) 대한골절학회 2001 대한골절학회지 Vol.14 No.2

Purpose: The purpose of this study was to compare the clinical results of subtrochanteric fractures which were treated with compression hip screw, intramedullary nailing and Rowe plate. Materials and Methods: From 1991 to 1999, 84 cases of subtrochanteric fractures were treated in Chonnam national university hospital. Among them, 25 cases were treated with compression hip screw, 18 cases with interlocking IM nailing and 32 cases with Rowe plate. Excluding pathologic fracture, there were 24 cases(group A), 16 cases(group B) and 30 cases(group C) of subtrochanteric fractures which were followed over 1 year. Mean follow up period was 18, 21, 24 months each. We compared the fracture pattern, operation time, operation method, additional fixation, bone union and complications among the groups. Results: We devided subtrochanteric fracture into below class II and above class III based on Seinsheimer classification. The overall clinical results were 1 case below class II, 22 above III in group A, 12 below II, 6 above II in group B, and 4 below II, 26 above III in group C. The average operation time was 153 minutes in group A, 166 in group B, and 150 in group C. Additional wiring was performed in 15 cases in group A, 1 in group B and 6 in group C. Interfragmentary screw fixation was performed only in group A(12 cases). Bone graft was performed in 6 cases in group A, 6 cases in group B and 11 cases in group C. The complications were as follows; delayed union 1 case in group A, 2 cases in group B and 6 cases in group C.; Nonunion only 1 case in group B; varus deformity 4 cases in group B and 2 cases in group C; metal failure 1 case in group B and 1 case in group C. Conclusions: In treatment of subtrochanteric fractures, compression hip screw was applied to more communited fractures than intramedullary nail, but with additional fixation safe union and excellent clinical outcomes obtained. For intramedullary nailing, great care should be taken not to produce varus malalignment. In plate fixation, we should keep in mind the possibility of metal failure and varus malalignment. Weight bearing should be delayed.

자가 골 - 슬개건 - 골 및 슬괵건을 이용한 전방십자인대 재건술후 결과 비교

송은규(Eun Kyoo Song),설종윤(Jong Yoon Seol),윤택림(Taek Rim Yoon) 대한슬관절학회 2000 Knee Surgery and Related Research Vol.12 No.2

Purpose : To compare the clinical and radiologic results of the anterior cruciate ligament(ACL) recon- struction between bone-patellar tendon-bone autograft and doubled semitendinosus and gracilis autograft Materials and Methods: 45 patients out of 235 ACL reconstructions with bone-patellar tendon- bone(BPTB) autograft and 47 patients out of 178 ACL reconstructions with doubled semitendinosus and gracilis were included in this study. Average follow-up period were 19 months in BPTB autograft and 17 months in doubled semitendinosus and gracilis autograft. There were no differences in preoperative parameters(age, sex, instability). Results: There were no significant differences between two groups with respect to functional result(Lysholm knee score), degree of laxity and range of motion at final follow-up. However, the parap- atellar complications, especially anterior knee pain after long distance walking or exercise, and quadriceps weakness were less occurred in doubled semitendinosus and gracilis autograft than in BPTB autograft. Conclusion : ACL reconstruction with doubled semitendinosus and gracilis autograft is a good alternative choice in reducing parapatellar complications and in achieving functional stability of knee joint.

경골 근위부 절골술 후 슬관절 관절간격의 회복

송은규(Eun Kyoo Song),설종윤(Jong Yoon Seol),정광철(Kwang Cheul Jeong),최진(Jin Choi) 대한슬관절학회 2002 Knee Surgery and Related Research Vol.14 No.1

Purpose : The purpose of this study was to evaluate whether the medial joint space could be restored by HTO in osteoarthritic knee associated with varus deformity and to evaluate its clinical results. Materials and Methods: HTO for medial gonarthrosis was performed in 65 knee joints of 59 patient. The median follow-up period was 36 months. The femoro-tibial angle(FTA) and joint space distance of medial and lateral compartment of the knee was measured on the weight-bearing antero-posterior plain radiogram. And the clinical results were evaluated by HSS knee score composed of pain, function, range of motion, muscle strength, flexion deformity and instability. Results: Medial joint space distance was restored to 2.9 mm in average at postoperative 3 years from 1.8 mm in average preoperatively. Also the lateral joint space distance was maintained without decrease. FTA was corrected from varus 6.3 degree in average preoperatively to valgus 7.3 degree in average at three years postoperatively. HSS score was improved from 69.1 point in average preoperatively to 95 points in average at three years postoperatively. The group of increased joint space distance showed more improved HSS score and more corrected FTA than the unchanged group (p<0.05). When the change of HSS score was compared according to the postoperative FTA, the group, FTA was corrected 7 degree or more had more improved clinical results and more increased joint space distance (p<0.05). Complications were pain or tenderness on the fibular osteotomy site in seven knees, nonunion of fibular osteotomy in seven knee, transient peroneal paresis in four knees and delayed union of tibial osteotomy in one knee. Conclusion: At three years follow up after HTO, there was restoration of joint space of the medial compartment of the knee. Also we found the fact that the joint space widening was correlated with clinical improvement. These results suggest that the correction angle of valgus 7 degree or more may have better clinical outcomes.