내측 설상골에 발생한 전 경골건에 의한 견열 골절 (1예 보고)

안수한,김형천,김광열,윤형조,김인열,Ahn, Su-Han,Kim, Hyung-Chun,Kim, Kwang-Yeol,Yoon, Hyeong-Jo,Kim, In-Yeol 대한족부족관절학회 2010 대한족부족관절학회지 Vol.14 No.2

Avulsion fracture of medial cuneiform by tibialis anterior tendon is quite rare. It has been reported about the avulsion fracture and surgical repair of tibialis anterior tendon rupture at distal insertion site of medial cuneiform in Korea. We report a case of right foot medial cuneiform avulsion fracture by tibialis anterior tendon after autobike accident and describe this case with a review of literature.

Haglund씨 병에서 시행한 내시경적 감압술의 결과

안수한,조형래,홍성확,왕태현,Ahn, Su-Han,Cho, Hyung-Lae,Hong, Seong-Hwak,Wang, Tae-Hyun 대한족부족관절학회 2008 대한족부족관절학회지 Vol.12 No.2

Purpose: Haglund's disease represents a painful heel caused by mechanically induced inflammation of the retrocalcaneal bursa and insertional Achilles tendinosis may coexist. Traditional open surgery can cause complications such as skin breakdown, painful scar and altered sensation around the heel. Endoscopic treatment offers the advantages that are related to minimally invasive procedure and we evaluate the clinical results and operative techniques of endoscopic decompression of retrocalcaneal space for Haglund's disease. Materials and Methods: Our retrospective study included seven heels in six consecutive patients for which nonoperative treatment had failed and endoscopic decompression was performed. The mean age was forty-one years (range, 28 to 53 years). All of the patients had typical complaints of inflammation of the retrocalcaneal bursa and Fowler-Philip angle of more than $75^{\circ}$ and positive parallel pitch lines were present on the lateral calcaneal radiograph. The endoscopic procedure consists of the resection of inflamed retrocalcaneal bursa and enough bone to prevent impingement of the bursa between the calcaneus and Achilles tendon. All patients were evaluated with radiologic angle, visual analogue scale (VAS) for pain and Ogilvie-Harris functional score. The mean follow-up was 18 months (range, 15 to 21 months). Results: The mean operation time was 61 minutes (range, 50 to 85 minutes). VAS for pain and Fowler-Philip angle were decreased from preoperative 8.7 and $82^{\circ}$ to postoperative 2.3 and $57^{\circ}$, respectively. One patient with ankylosing spondylitis had a fair result, 2 patients had good results and the remaining 3 patients had excellent results according to Ogilvie-Harris functional score. There were no surgical complications such as infection, Achilles tendon avulsion or abnormal heel sensation. Conclusion: The endoscopic decompression for Haglund's disease was demonstrated to have several advantages including low morbidity, allowance of functional rehabilitation, short recovery time and quick sports resumption. However a comparative study is needed to determine the value of endoscopic decompression and particular caution should be exerted for the enthesiopathy.

Candida pelliculosa에 의한 진균성 슬관절염의 관절경적 치료 - 증례 보고 -

김형천,안수한,김광열,황연수,이지훈,이동은,Kim, Hyung-Chun,Ahn, Su-Han,Kim, Kwang-Yeol,Hwang, Youn-Soo,Lee, Ji-Hoon,Lee, Dong-Eun 대한관절경학회 2013 대한관절경학회지 Vol.17 No.1

슬관절에서의 칸디다 감염증은 매우 드물다. 칸디다 감염증은 임상 증상이 뚜렷하지 않아 진단이 어렵다. 슬관절에서 발생하는 칸디다 감염 중 Candida albicans가 가장 흔한 균주이고 Candida pelliculosa는 거의 보고된 적이 없는 균주이다. 이에 저자들은 스테로이드 주사 후 슬관절의 Candida pelliculosa 감염증이 발생한 1예를 반복적 관절경하 변연 절제술 및 세척술 그리고 관절경하 항진균제 혼합 시멘트정 충전물 삽입술을 이용하여 성공적으로 치료하였기에 보고하는 바이다. Candida infection of knee joint is very rare. Diagnosis of Candida infection is difficult due to lack of obvious clinical symptoms. Candida albicans is the most common strain in Candida infection of knee joint, but Candida pelliculosa has been rarely reported. We report a case of Candida pelliculosa infection of knee after intra-articular steroid injection, which was treated successfully by repeated arthroscopic debridement and irrigations and arthroscopic implantation with antifungal agent-impregnated cement bead spacer.

Acutrak 나사를 이용한 족관절 내과 골절의 치료

김광열,김형천,안수한,윤형조,조성준,Kim, Kwang-Yeol,Kim, Hyoung-Cheon,Ahn, Su-Han,Yun, Hyoung-Jo,Cho, Sung-Jun 대한족부족관절학회 2010 대한족부족관절학회지 Vol.14 No.1

Purpose: The purpose of this study is to evaluate the clinical and radiologic results of using Acutrak screws for treating ankle medial malleolar fracture. Materials and Methods: We reviewed 38 cases of ankle medial malleolar fracture treated with Acutrak screws from February 2005 to May 2008. Results: In clinical result, there were 30 exellent cases, 7 good cases, 1 fair case. In radiologic result, there is no case with reduction loss. Average union time is 10.5 weeks. Conclusion: We conclude that Acutrak screw fixation is a useful method for ankle medial malleolar fracture, there are many advantages in accurate anatomical reduction, small incision, short operative time.

연부조직 교정술에 의한 무지 외반증의 치료

최호,김훈,조형래,고영철,박영일,안수한,Choi, Ho,Kim, Hoon,Cho, Hyung-Lae,Ko, Young-Chul,Park, Young-Il,Ahn, Su-Han 대한족부족관절학회 2003 대한족부족관절학회지 Vol.7 No.1

Purpose: We are going to present a report from clinical and radiographic results of hallux valgus done only by soft-tissue procedure, when intermetatarsal joint is totally unfit under mild to moderate deformity. Materials and Methods: As a retrospective study, among all the patients who went under the surgery for hallux valgus, and of those who were possible to follow up,(excluding those whose intermetatarsal joint is fit) it was done over 28 cases (18 patients). the soft-tissue procedure was all done by Modified Mc Bride. Results: Hallux valgus angle and intermetatarsal angle each showed correction of $19.4^{\circ}$ and $5.2^{\circ}$, and from the final follow up, they were each decreased by $5.1^{\circ}$ and $1.5^{\circ}$. 21% (6case) were recurred, in one case, the intermetatarsal angle decreasing 120 and the other 5 case all decreased by $13^{\circ}$. Conclusion: when the intermetatarsal joint is unfit and there is no degenerative change, and, if the intermetatarsal angle is not large, moderate hallux valgus can show a good result, just by the distal soft-tissue procedure. a critical indication and a well through out preparation can reduce unneccessary surgeries.

원위 쇄골 골절의 치료에서 Hook 금속판의 이용

김형천 ( Hyung Chun Kim ),김광열 ( Kwang Yeol Kim ),안수한 ( Su Han Ahn ),윤형조 ( Hyeong Jo Yoon ),김인열 ( In Yeol Kim ) 대한골절학회 2011 대한골절학회지 Vol.24 No.1

목적: 본 연구는 원위 쇄골 골절 치료에서 Hook 금속판을 이용한 수술적 치료의 임상적 결과를 평가하고자 하였다. 대상 및 방법: 2008년 4월부터 2010년 3월까지 원위 쇄골 골절로 Hook 금속판을 이용하여 수술한 10명의 환자를 대상으로 하였으며, 수술 후 평균 추시 기간은 10 (4∼26)개월이었다. 정복 및 골유합의 평가는 수술 직후 및 최종 방사선 소견을 이용하였고, 기능적 평가는 Kona의 기능적 평가 기준 및 UCLA score를 사용하였다. 결과: 방사선학적 평가에서는 10예 모두에서 해부학적 정복 및 골유합을 확인하였으며, Kona의 기능적 평가기준에 의해 우수 7예, 양호 3예였고, UCLA 평균점수는 33.3 (29∼35)점으로 우수 6예, 양호 4예였다. 합병증으로는 1예에서 술 후 쇄골 간부 골절이 발생하였고, 1예에서 골 용해가 발생하였다. 그 외 피부자극, 감염증, 나사못의 이완, 금속판의 파단 등 다른 합병증은 관찰되지 않았다. 결론: Hook 금속판을 이용한 고정법은 원위 쇄골 골절의 치료에서 만족스런 정복과 견고한 고정을 얻을 수 있고, 불유합의 발생이 적으며, 임상적 결과가 우수한 수술 방법이라고 사료된다. Purpose: To evaluate the result of distal clavicle fracture treated by Hook plate (LCP clavicle hook plate, Synthes(R), Paoli, Switzerland). Materials and Methods: 10 patients with distal clavicle fracture treated by Hook plate from April 2008 to March 2010 were analyzed. The average follow-up period was 10 (range 4 to 26) months. The reduction was qualified and evaluated according to the immediate post-operative, final radiographs. We analyze the result by UCLA score and Kona`s functional evaluation. Results: By radiologic evaluation, all cases showed anatomical reduction and solid union. By Kona`s functional evaluation, there are 7 cases with excellent results, 3 cases with good results. The UCLA score was average 33.3 (range 29 to 35) points followed by 6 excellent cases, 4 good cases. As complication, 1 case showed post-operative clavicle shaft fracture and 1 case showed acromial osteolysis on X-rays. We found no complications such as skin irritation, infection, loosening of screws, and plate failure. Conclusion: The Hook plate fixation for distal clavicle fracture is considered effective method for satisfactory reduction and rigid fixation, a lower incidence of nonunion and excellent clinical result.

골다공증 환자에서 발생한 상완골 근위부 및 간부 골절의 Polarus 골수정을 이용한 치료

김형천 ( Hyung Chun Kim ),이동은 ( Dong Eun Lee ),김광열 ( Kwang Yeol Kim ),안수한 ( Su Han Ahn ),황연수 ( Youn Soo Hwang ) 대한골절학회 2013 대한골절학회지 Vol.26 No.1

목적: 고령의 골다공증 환자에서 발생한 상완골 근위부 및 간부 골절에서 Polarus 골수정을 이용한 치료의 유용성을 평가해보고자 한다. 대상 및 방법: 고령의 골다공증 환자에서 발생한 상완골 근위부 골절과 간부에서 Polarus 골수정 고정술을 시행한 23예를 대상으로 하였다. 골절 형태는 근위부 골절이 9예, 간부 골절이 10예, 근위부와 간부를 동시에 침범한 골절이 4예였다. 방사선학적 결과는 골유합과 잔여 변형각 정도를 포함하였다. 잔여 변형각은 경간각(neck-shaft angle)과 간부 각변형(shaft angulation)으로 평가하였다. 임상적 평가는 American Shoulder and Elbow Surgeons (ASES) 점수 평가법을 이용하여 분석하였다. 결과: 모든 예에서 골유합을 보였으며, 평균 골유합 기간은 16.5주였다. 골유합 당시 평균 경간각은 135°였고, 내반 변형은 발생하지 않았다. 5° 이상의 간부 각변형이 3예 발생하였다. 수술 후 기능 평가에서 평균 ASES 점수는 86.7점이었다. 결론: Polarus 골수정은 수술 후 빠른 재활 운동이 가능할 뿐만 아니라 상완골두 무혈성 괴사나 불유합 소견 없이 골유합을 보여줌으로써 노인 골다공증 환자의 상완골 근위부 및 간부 골절 치료에 유용하다. Purpose: To assess the effectiveness of optimal treatment of proximal humeral fractures and humeral shaft fractures in elderly patients with osteoporosis using the Polarus nail. Materials and Methods: Twenty-three patients with proximal humeral and humeral shaft fractures in elderly osteoporosis patients were treated using the Polarus intramedullary nail. Nine patients had proximal humeral fracture, 10 had humeral shaft fracture and 4 had the proximal humeral frac-ture extended diaphyseally. Radiological outcomes included the bone-union and the degree of re-sidual deformity. The residual deformities of the proximal humerus were assessed by the neck-shaft angle and the shaft angulation. Clinical outcome was assessed with the American Shoulder and Elbow Surgeons (ASES) score. Results: All cases had bony union and the mean union period was 16.5 weeks. The average neck/shaft alignment at the time of bone union was 135° and varus deformities of neck-shaft angle was not seen in all patients. Varus shaft angulation was seen in 5 patients. The mean ASES score after surgery was 86.7 points. Conclusion: The Polarus intramedullary nail is effective for the treatment of proximal humeral and humeral shaft fractures in elderly patients with osteoporosis because it not only enables early postoperative mobilization, but also obtains bone-union without avascular necrosis and nonunion.

쇄골 원위단에 발생한 골용해증

구정회(Jung Hoei Ku),김진완(Jin Wan Kim),고영철(Young Chul Ko),조형래(Hyung Lae Cho),안수한(Su Han Ahn) 대한정형외과학회 2005 대한정형외과학회지 Vol.40 No.6

쇄골 원위단의 골용해증은 드문 질환이며 그 원인이나 발병 기전에 대해서도 잘 알려져 있지 않다. 저자들은 각각 급성 및 만성 외상 후에 발생한 쇄골 원위단의 골용해증 2예를 진단하고 보존적 치료에 호전을 보이지 않아 쇄골 원위단 절제술로 치료하여 만족할 만한 결과를 얻었기에 이를 문헌 고찰과 함께 보고하며 본 증례를 통해 쇄골 원위단의 골용해증의 발병 기전과 감별 진단, 치료에 대해 검토해보고자 한다. Osteolysis of the distal clavicle is a rare disease and its etiology and pathogenesis are poorly understood. We report two cases of the osteolysis that were resulted from acute blunt shoulder trauma and chronic repetitive one. After diagnosis, the two patients did not have shown the response to conservative management, so we performed distal clavicle resection on them and the results were satisfactory. Through these cases, we discuss the pathogenic mechanism, differential diagnosis and treatment options for the osteolysis of the distal clavicle.

室素의 晩期追肥가 水稻의 生育과 收量에 미치는 影響

韓文甲,安壽奉 충남대학교 농업과학연구소 1985 農業技術硏究報告 Vol.12 No.2

In order to obtain information necessary for attaining maximum yield of rice by increasing nitrogen efficiency, effects of top dressing of nitrogen fertilizer at the later part of growing season were investigated and results obtained are summurized as follows: 1. The increased application of nitrogen fertilizer was very effective in increasing leaf areas and net assimilation rate of rice plants. The spikelets number per hill was also increased due to heavy nitrogen fertilizer. 2. The concentrated top dressing at the later part of plant growth apparently increased the crop growth rate at the reproduction stage and ripening stage of rice, respectively. The nitrogen efficiency was greatly improved by the concentrated top nitrogen dressing through the increase of effective tiller number and the improvement of production organ to non productive organ ratio. 3, The concentrated top nitrogen dressing at the later growing season was considered to be one of the most effective methods of fertilizer applications as well as cultivation of fertilizer resistant varieties for the high yield of rice and improving soil fertility.