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      • 슬괵건을 이용한 전방십자인대 재건술의 임상적 결과

        송은규,이근배,신상규,김현종,Song Eun Kyoo,Lee Keun Bae,Shin Sang Gyoo,Kim Hyun Jong 대한정형외과스포츠의학회 2002 대한정형외과스포츠의학회지 Vol.1 No.1

        Purpose: To evaluate the clinical results after anterior cruciate ligament (ACL) reconstruction with hamstring tendon and Ligament Anchor (LA) screw, which is newly designed for fixation of graft into femur. Materials and Methods: Fifty eight patients who were followed up at least more than 2 years after ACL reconstruction with four strands of Hamstring tendon and LA screw were included in this study. The graft was fixed with LA screw at femoral tunnel and with only bioabsorbable interference screw at tibial tunnel. The mean follow-up period was 28 months. The clinical results were evaluated by physical examination and Lysholm knee score. Widening of bony tunnel and anterior laxity difference compared with normal side by instrumented anterior laxity test with Telos(R) (Telos stress device; Austin & Associates, Inc., Polston, US) were evaluated. Results: The Lysholm knee score improved from 60.0 points preoperatively to 94.0 points at last follow up. On the Lachman test, there were mild (+) instability in 16 cases, moderate (++) in 24,severe (+++) in 18 preoperatively. 50 cases were converted to negative and 8 to mild instability at postoperative follow up. On instrumented anterior laxity test with Telos(R), difference between normal and affected knee on 20 lb was 12.9 mm in average preoperatively, and was decreased to 3.1mm at last follow-up. The femoral tunnel was widened from 10.6 mm postoperatively to 12.7 mm (21.1$\%$) at follow up on antero-posterior plane and from 10.7 mm to 12.4 mm (16.5$\%$) on lateral plane. Tibial tunnels was also widened from 9.8mm to 11.8mm (20.7$\%$) on antero-posterior plane and from 9.9mm to 11.7 mm ($18.9\%$) on lateral plane. Complications were: anterior knee crepitus in 17 case, quadriceps muscle atrophy(>3 cm) in 6, penetration of screw over the lateral femoral cortex in 5, saphenous nerve paresthesia in 2.Conclusions: ACL reconstruction with hamstring tendon and LA screw was one of the choice of grafts and fixation devices in restoring knee stability and in improving clinical results with little complications such as excessive widening of bony tunnel and anterior knee pain

      • 포상 연부 육종 - 2례 보고 -

        정성택,서형연,신상규,박용철,Jung, Sung-Taek,Seo, Hyoung-Yeon,Shin, Sang-Gyoo,Park, Yong-Cheol 대한근골격종양학회 2003 대한골관절종양학회지 Vol.9 No.2

        As we know, alveolar soft part sarcoma is usually found at the head region in children and thigh in adults. It is very rare tumor that has poor prognosis due to its late detection after distant metastasis in spite of its slow growth rate. It is histologically characterized by pseudoalveolar pattern tumor cells. And metastasis usually occur in the site of lung, brain and skeleton in order lately. We have managed two cases of the sarcoma, one which took place in relatively rare part, pelvic bone and has spread to the brain, the other which primarily occured in the calf. For its varity, we report these two cases with reviewing of the literatures.

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        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.

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