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안상천,김병곤,최창환 동아대학교 건설기술연구소 2000 硏究報告 Vol.24 No.1
As the result of this study, first, this study suggested the new residential pattern for the elder to make their matured social experience work and to stabilize their aged life, preparing the aging society. Second, this study suggested the development of independent silver town. This has the basic frame to attempt to support them economically by securing the auxiliary facilities within the complex and returning to the profitable business. Establishing the union between the residents in the complex can work as the means of a self-governing activity and the communication between neighborhoods. And, as the policy suggestion derived from this study, first, the necessity of developing the aged facilities located in the suburban is presented. The development within the greenbelt with this condition can be an example. Second, new establishing policy for the elder is needed. Because the expenditure of Korean government is confined to the free old-age facilities, in the case of constructing silver town, the difficult in the cost of construction will accrue. So, leading companies' turning to public-welfare service, and complementing and deciding the law through the political supports of government are needed seriously.
대퇴골 과상 및 과간 골절의 관혈적 정복 및 내고정술후 발생한 감염성 불유합의 치료
장호근,이응주,안상천 대한골절학회 1996 대한골절학회지 Vol.9 No.4
The postoperative complications in open reduction and internal fixation of supracondytar and intercondylar fractures of the femur include leg length discrepancy, Infection, skin necrosis. irritation by implants, valgus or varus deformity. bony destruction associated with vascular disturbance, instability of the knee joint and translation of the fractured surface. The most vulnerable complication among them may be infection. Then infected nonunion is dangerous to the patients and its treatment is very difficult. Authors evaluated 25 cases of 25 patients who were treated and followed up evaluation over one year in the department of Orthopaedic Surgery, College of Medicine, Hallym University from January, 1988 to June, 1995. All cases were treated by open reduction & internal fixations. Four cases of them had developed infected nonunion. After we treated these cases we could reach following results: 1. The cause of infection was primarily staphylococcus aureus in all cases. 2. Among 4 cases of infected nonunion, externa1 fixator was preformed in 3 patients and interlocking IM nailing in remainder. 3. The infection was managed with intravenous antibiotics. frequent irrigation, insertion of antibiotic impregnated beads and daily dressing. 4. Erythrocyte sedimentation rate was normalized at average 8.5 months(range, from 1.5 to 26 months). 5. The union was accomplished at mean 5.4 months in 2l cases without infection and at mean 17.7 months(range, Sam 10 to 35 months) in 4 cases with infected nonunion after infection developed. 6. The main complications were limitated range of motion of the knee (30 to 100 degree flexion) and shortening of affected extremity. 7. In conciusion. we suggest that early removal of implant in situ, external fixation and bone graft after infection controlled is an adequate plan for the treatment of infected nonunion in supracondylar and intracondylar fractures of the femur.
박현철,박현식,안상천,조상현,김상수,장진,Park, Hyun-Chul,Park, Hyun-Sik,Ahn, Sang-Cheon,Cho, Sang-Hyun,Kim, Sang-Soo,Chang, Jin The Korean Society for Microsurgery 2011 Archives of reconstructive microsurgery Vol.20 No.1
Purpose: We compared wound healing between the conventional tie-over dressing and silicone sheeting after skin grafting in patients with skin defects. Materials and Methods: Of a total of 30 cases of skin defects, 15 underwent conventional tie-over dressing and the remaining 15 underwent silicone sheeting skin grafting, we compared hematoma formation and infection status between the 2 techniques 1 and 2 weeks after operation Results: Hematoma was not observed in all cases. The wound infection rate decreased in silicone group. Conclusions: Silicone sheeting skin graft may be helpful in reducing wound infection.
Locking Compression Plate를 이용한 족근 관절 외과 골절의 치료
하성식,홍기도,정남식,심재천,안상천,Ha, Sung-Sik,Hong, Ki-Do,Chung, Nam-Sik,Sim, Jae-Cheon,Ahn, Sang-Cheon 대한족부족관절학회 2005 대한족부족관절학회지 Vol.9 No.1
Purpose: The purpose of this study was to investigate usefulness of locking compression plate (LCP) as an open reduction technique by evaluating clinical results obtained from the patients with lateral malleolar fracture treated by internal fixation using LCP after open reduction. Materials and Methods: Among the patients with lateral malleolar fracture, the 28 patients who were treated by internal fixation using Locking compression plate after an open reduction and were able to be followed up for more than 6 months were included in this study. Final postoperative evaluation was done based on the Meyer's clinical and radiologic evaluation system. Results: All cases achieved anatomical reduction and fixation of the reduction postoperatively. 28 minutes were taken meaningly from the incision to the fixation of LCP plate after the anatomical reduction. Everage bony union time was 8.2 weaks, and the result was excellent in 23 cases (82%), good in 5 cases (17%) and poor result was abscent according to the criteria of Meyer et al. One case of post traumatic arthritis and one case of superficial infection on the operation site were found, but non-union, delayed union and malunion were not occurred. Conclusion: The internal fixation after open reduction using LCP is an effective treatment method in treating lateral malleolar fracture of the ankle since it offers advantages including easy application and a greater stability due to its capability of maintaining exact anatomical reduction even though the screw does not penetrate the medial cortex of fibular to add the stability and rigidity of the fixation.
최소 침습적 외측 금속판 고정술을 이용한 경골 원위 골간단 골절의 치료
홍기도 ( Ki Do Hong ),하성식 ( Sung Sik Ha ),정남식 ( Nam Sik Chung ),심재천 ( Jae Cheon Sim ),안상천 ( Sang Cheon Ahn ) 대한골절학회 2006 대한골절학회지 Vol.19 No.1
목적: 경골 원위 골간단부 골절에서 최소 침습적 외측 금속판 고정술을 시행한 환자를 대상으로 결과를 분석하여 그 유용성을 알아보고자 하였다. 대상 및 방법: 2002년 3월부터 2004년 9월까지 원위 경골 골간단 골절로 최소 침습적 외측 금속판 고정술을 시행한 최소 1년 이상의 추시가 가능 하였던 20예의 환자를 대상으로 하였으며, AO/OTA 골절 분류에 의한 A1형 골절이 5예, A2형이 12예, A3형이 3예였으며, 개방성 골절이 2예였다. 결과의 판정은 방사선학적 평가와 Daniel 등에 의한 임상적 평가 방법과 합병증의 병발 유무를 조사하였다. 결과: 전예에서 방사선학적 골 유합을 얻을 수 있었고, 평균 16.4주 (11∼22주)로 관찰되었다. 임상적 결과는 모든 경우에서 양호 이상으로 관찰되었으며, 다른 추가적인 합병증의 발생은 보이지 않았다. 결론: 경골 원위 골단간부 골절에서 최소 침습적 외측 금속판 고정술은 내측 금속판과 마찬가지로 연부 조직의 손상을 최소화하면서 감염의 위험과 불유합의 빈도를 줄여 높은 기능적 회복을 얻을 수 있는 유용한 방법으로 생각되며, 경골 내과골 금속판 삽입부의 연부조직 손상 시 고려할 수 있는 좋은 대체 방법의 하나로 생각된다. Purpose: To evaluate the efficiency of lateral plate fixation using minimally invasive plate osteosynthesis (MIPO) technique as a treatment of distal tibial metaphyseal fracture. Materials and Methods: Among the patient who were treated from March, 2002 to September, 2004, the cases of twenty patients with distal tibial metaphyseal fracture treated by lateral plate fixation using MIPO technique who were able to be followed up for at least one-year period were reviewed in this study. According to AO/OTA classification, five were type A1, twelve cases were type A2 and other three cases were type A3, and among them two cases were open fracture type I according to the Gustillo-Anderson classification. Radiologic studies and clinical assessment described by Daniel et al and complication following the treatment were evaluated. Results: At a mean of 16.4 weeks (range 11 to 23), all fractures united without secondary procedures. According to clinical assessment, all cases had good and excellent result, and there were no complications. Conclusion: The lateral plate fixation using MIPO technique of distal tibial metaphyseal fracture is an efficient method of treatment with high functional recovery rate which minimize soft tissue damage, decreases the risk of infection and incidence of nonunion at the same time as the classic MIPO technique does, and it is a useful alternative method when there is a anteromedial soft tissue damage.