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최장석,한문성,손찬모,변만호 인제대학교 1995 仁濟醫學 Vol.16 No.4
골절의 치유과정 중 가골형성 시기에 골막 및 골내막의 간엽세포들이 분화의 과정을 거쳐서 섬유성 연골의 가골을 형성하기 시작한다. 저자들은 성장기에 있는 36마리의 백색 가토의 경골 간부에 절골술을 시행한 후 절골술 부위의 고정은 pin and resin으로 외고정을 실시한 후 새로운 골형성 과정을 관찰하기 위하여 술후 1주일 간격으로 방사선 촬영을 실시한 후 새로운 골형성 과정을 평가하였다. 저자의 실험에 의하면 수술시 골막을 제거한 경우에는 골절의 치유가 지연되었으며 골내막을 제거한 경우에는 큰 영향을 미치지 못하였다. 이상의 소견으로 골절유합에 있어 골막이 골내막보다 더 중요한 역할을 하는 것으로 사료된다 In callus formation stage of fracture heating, periosteal and endosteal mesenchymal cells begin to differentiate and form the fibrocartilaginous callus. But a long standing controversy exists as to the osteogenic potential of periosteum and endosteum. Our study was designed to determine the role of periosteum and endosteum in fracture healing of rabbits. Transverse osteotomy was performed in the tibia diaphysis and the osteotomized bone was stabilized with a pin and resin external fixation. The rabbits were divided into four experimental groups; Group 1-The periosteum and endosteum were not removed. Group 2-The endosteum was removed. Group 3-The periosteum was removed. Group 4-The periosteum and endosteum were removed. Following operation, the process of new bone formation was monitored by radiographs weekly. The appearance of fracture callus on conventional radiographs is an important finding in the assessment of fracture healing. The fracture healing was delayed in the group that the periosteum had been removed at operation but was not largely influenced in the group that the of scrapig of endosteum. This result suggests that the periosteum plays a more important role in fracture healing than the endosteum does.
최홍준,김대욱,강영훈,박종호,손찬모,Choi, Hong-Joon,Kim, Dae-Wook,Kang, Yeong-Hun,Park, Jong-Ho,Son, Chan-Mo The Korean Foot and Ankle Society 2017 대한족부족관절학회지 Vol.21 No.2
Purpose: Stiffness in the first metatarsophalangeal joint after surgery for hallux valgus has been reported. The goal of this study was to test the efficacy of releasing plantar aponeurosis for improving the range of extension in the first metatarsophalangeal joint that was limited after hallux valgus surgery. Materials and Methods: Thirteen patients (1 man, 12 women [17 feet]; median age, 54.4 years; range, 44~69 years) with limited first metatarsophalangeal joint extension after hallux valgus surgery, who underwent an additional procedure of plantar aponeurosis release between March 2015 and August 2015, were included. Subsequently, the passive range of extension in the first metatarsophalangeal joint was evaluated via knee extension and flexion positions. Hallux valgus angle, inter-metatarsal angle, distal metatarsal articular angle, and talo-first metatarsal angle were measured on weightbearing dorsoplantar and lateral radiographs of the foot preoperatively. Results: The mean range of extension for the first metatarsophalangeal joint improved significantly, from $2.5^{\circ}$ to $40.9^{\circ}$ in the knee extension position (p<0.00). The mean extension range for the first metatarsophalangeal joint also improved, from $18.2^{\circ}$ to $43.2^{\circ}$ in the knee flexion position (p<0.00). In all patients, congruence of the first metatarsophalangeal joint was recovered. Conclusion: Plantar aponeurosis release is an effective additional procedure for improving the extension range of the first metatarsophalangeal joint after hallux valgus surgery.