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초기 비외상성 대퇴골두 무혈성 괴사의 골 이식에 대한 임상적 고찰
최원식 ( Won Sik Choy ),김환정 ( Whan Jeong Kim ),이광원 ( Kwang Woo Lee ),유천환 ( Chun Hwan Yoo ),송대화 ( Dae Hwa Song ),김규현 ( Kyou Hyun Kim ),옹상석 ( Sang Suk Ong ) 대한고관절학회 1996 Hip and Pelvis Vol.8 No.2
The authors retrospectively reviewed 21 patients who underwent 22 bone grafting procedures for early atraumatic avascular necrosis of femoral head to evaluate effectiveness of the procedure. The minimum follow up period was 2 years and evaluation included clinical results using Merle d'Aubigne-Postel scale as modified by Charnely and radiographs using Ficats staging system. The result were as follows. l. All case". were males and 20 patients have bilateral involvement. The ages ranged from 26 to 67 years and mean age was 46.1 years. 2. According to the Ficat stage, Stage I was 8 cases (36%), Stage II were 14 cases (64%). At last follow up, Stage I were 1 case (5%), Stage II were 4 cases (18%), Stage III were 8 cases (36%) and Stage IV were 9 cases (41%). 3. The successful results in clinical and roentgenological evaluations were obtained in 5 cases (23%). Progressive collapse was not prevented in 17 cases (77%). 4. The role of core decompression with bone grafting in precollapse stage of avascular necrosis of femoral head is uncertain.
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이광원,최원식,송대화 대한골절학회 1997 대한골절학회지 Vol.10 No.2
A subtalar dislocation of the foot is a dislocation of the talonavicular and talocalcaneal joints while the tibiotalar relationship is unchanged. Posterior subtalar dislocation is a very rare injury. Only a few cases were reported previously in The literature. The authors treated a 27 year-old man who sustained the posterior subtalar dislocation in a high energy impact motor vehicle accident. The dislocation of the subtalar joint was reduced by closed means with excellent clinical result.
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최원식,김환정,김남훈,김규현,송대화 대한척추외과학회 1997 대한척추외과학회지 Vol.4 No.1
Study of Design : This is a report of the effect of automated percutaneous lumbar discectomy (APLD) for lumbar disc herniation. Eighty seven patients with symptomatic lumbar disc herniation who had not been relieved by conservative managements were treated with APLD from January 1991 to April 1994. Among them 71 patients were followed for more than two years. Objectives : Percutaneous discectomy has been widely used for the lumbar disc herniation in recent years because it is simple, safe and semi-invasive. The aim of this current study was to investigate the effect of APLD for lumbar disc herniation. Literature Review : Percutaneous lumbar discectomy for lumbar disc herniation was developed by Hijikata et al in 1975. Since then, their original procedure has been used and modified by other researchers, who have published their clinical results. In 1986, Kambin and Sampson reported an 85% success rate and in 1985, Onik et al first reported on the use of an automated reciprocating suction cutter to perform percutaneous discectomy. Materials and Methods : Every patient had preoperative symptoms suggestive of either one or two level herniated lumbar disc, which was confirmed by magnetic resonance imaging. There were 55 men (77%) and 16 women (23%), aged from 14 to 59 years (average 27.4 years). Average duration of procedure was 33 minutes, average amount of disc material 4.4 grams and average hospital stay 9.1 days(range, 3-21 days). Clinical evaluation was made after APLD with the Japaneses Orthopaedic Association (JOA) scoring system. Patients with scores higher than 12 points (out of 15) were included in the "successful" group; all others were included in the "unsuccessful" group. Results : The results were satisfactory in 57 patients (81%) and satisfactory in 14 patients (19%). One patient ultimately underwent surgical discectomy for continued symptoms after the procedure. No intraoperative or postoperative serious complications occurred. Conclusions : APLD is safe and effective. Careful patient selection, correct use of instruments, sufficient evacuation, and adequate annular fenestration greatly enhance the chances of a successful outcome. Overall, APLD is believed to be an acceptable treatment technique for those patients with contained herniated nucleus pulposus.
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