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은승표,손한석,손종민,장주해,안동헌 대한골절학회 1996 대한골절학회지 Vol.9 No.3
Supracondylar fracture of the humerus is the most common fracture around the elbow joint in children, especially in the age from 4 to 9. 97% of The fractures are extension type and there are many problems in management such as the method of reduction and maintenance of reduction, Volkmann's ischemia, neurovascular injuries, cubitus varus or valgus deformity, and myositis ossificans etc. Currently the methods of treatment of supracondylar fracture include open reduction and pin fixation, closed reduction and percutaneous pin fixation, and closed reduction and immobilization by splint. 134 children with supracondylar fracture of humerus, conservatively 49 cases and operative 85 cases, were treated from January 1991 to October 1995 and were followed u p for at least 6 months. We analyzed the type of fracture, method of treatment and results and concluded that accurate reduction, minimizing soft tissue injury and maintenance of reduction are important factors for gaining good results.
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외측 경골과 골절에 대한 관절경하 치료와 고식적인 수술 방법간의 비교
김정만,한창환,손한석 대한골절학회 1996 대한골절학회지 Vol.9 No.3
The goals in the treatment of a tibial plateau fracture are to obtain a stable. aligned, mobile and painless joint and to minimize the risk of post-traumatic osteoarthritis. Most recently the management of tibial plateau fractures has been via arthroscopy. Proponents of arthroscopic techniques advocate their use not only to better visualize the surface of the tibia but also to evaluate the rest of the joint. This retrospective study compared the results of arthroscopic and conventional treatment of tibial plateau fractures from January 1988 through April 1995. Forty-seven knees of tibial plateau fractures were involved in this study. Sixteen of these patients were treated with arthroscopic reduction and autogenous bone graft with or without internal fixation, while the remaining 31 underwent underwent reduction, bone graft and internal fixation. The results are as follows: 1. The average time to full weight tearing was 10.2 weeks (range 7-14 weeks) in the arthroscopic group and I3..5 weeks(7.2-18 weeks$gt; in thc open reduction group. 2. The incider ce of lateral meniscus tear was 56%(9/16) in the arthroscopic reduction group and 29%(9/31) in the open reduction group. 3. Flexion of at least 130 was obtained in 81%(13/16) of arthroscopic reduction group, while only 58%(16/31) in the open reduction group. Full extension was obtained in 93%(15/16) of arthroscopic reduction group, and in 83%(26/31) in the open reduction group. 4. Complications occurred more frequently in the open reduction group than in the arthroscopic reduction group.
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이종서,정성수,이상국,손한석,김성민 대한척추외과학회 2000 대한척추외과학회지 Vol.7 No.3
연구 설계 : Marfan 증후군 환자들을 대상으로 척추의 이상 여부에 대해 후향적으로 고찰해 보았다. 목적 : Marfan 증후군의 임상적 소견 및 방사선학적 척추의 이상 소견에 대해 분석하고자 하였다. 문헌 고찰 : 척추 측만증과 후만 변형은 Marfan 증후군에 있어 흔해 발견되는 척추 이상 소견이다. 그러나 Marfan 증후군과 관련된 다른 척추의 이상에 대한 문헌상의 보고는 드문 실정이다. 재료 및 방법 : Marfan 증후군으로 진단 받은 32명의 환자에게서 Marfan 증후군과 관련된 척추 이상 소견에 대해 분석하였다. 기립상 전척추 방사선 사진에서 관상면과 시상면 상의 곡선을 Cobb씨의 방법을 이용하여 측정하였다. 척추 전방 전위증이나 경막 확장증과 같이 Marfan 증후군과 관련된 비교적 드문 척추의 이상 소견도 평가하였다. 결과 : 척추 측만증이 32명 중 18례(56.3%)에서 관찰되었다. 측만각은 평균 26˚였으며 흉부 만곡이 가장 흔하였다. 흉추부 후만, 요추부 전만 그리고 흉요추부 후만이 각각 27˚±13˚(0˚∼53˚), -42˚±13˚(-10˚∼-70˚) 그리고 9˚±12˚(-5˚∼45˚)로 측정되었다. 척추 전방 전위증이 2례(6.3%)에서 관찰되었는데, 1례는 15%의 전방 전위를 보였고, 다른 1례는 50%의 전위를 보였다. 2례의 경막 확장증을 자기 공명 영상 촬영을 통해 확인하였다. 결론 : Mafran 증후군에서 척추 측만증(56.3%)과 흉요추부 후만(50%)의 빈도가 높음을 알 수 있었다. 척추 전방 전위증의 빈도는 일반 보다 다소 높을 뿐이었다. 임상적으로 큰 의미는 없지만 경막 확장증은 유의한 진단적 가치를 지녔음을 확인하였다. Marfan 증후군에서 이러한 척추의 여러 이상 소견들을 염두에 두어야 할 것으로 생각된다. Study Design : This is a retrospective review on the spinal abnormalities in Marfan Syndrome. Objectives : To analyze clinical and radiological features of the spine in Marfan syndrome. Summary of literature : Scoliosis & Kyphosis are common spinal abnormalities in Marfan syndrome. Other spinal abnormalities associated with Mafran syndrome are rarely reported in the literature. Materials and Methods : the spinal abnormalities which can be associated with Marfan syndrome were analyxed in 32 patients who were diagnosed as Marfan syndrome, Coronal and sagittal curvatures on whole spine standing film were evaluated with Cobb's method. Uncommon spinal abnormalities whic can be associated with this syndrome, such as spondylolisthesis and dural ectasia were also evaluated. Results : scoliosis was identified in 18 of 32 patients(56%). The mean scoliotic angle was 26˚and thoracic curve was most common. Thoracic kyphosis, lumbar lordosis and thoracolumbar kyphosis were measured as 27˚±13˚(0˚∼53˚), -42˚±13˚(-10˚∼-70˚) and 9˚±12˚(-5˚∼45˚)respectively. Spondylosisthesis was presint in two cases(6.3%), one of whic was 15% slip and the other was 50% slip. Two cases of dural ectasia were confirmed with MRI. Conclusion : Marfan syndrom showed high incidence of scoliosis(56.3%) and thoracolumbar kyphosis(50%). The frequency of spondylolisthesis was only slightly higher than that in the general population. The dural ectasia is a common but little known abnormallity. Therefore it has a significant diagnostic value without clinical importance. In Marfan syndrome, we should keep these common and uncommon spinal abnormalities in mind.
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