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대퇴 골두 골내 결절종 : 1예보고 A Case Report
임수재 순천향의학연구소;Soonchunhyang Medical Research Institute 2004 Journal of Soonchunhyang Medical Science Vol.10 No.2
Intraosseus ganglion cysts are uncommon, benign, and usually found within long bone, the lesions appear grossly and histologically similar to their tissue counterparts exhibiting a thick fibrous wall and filled with a slimy, mucin rich gelatinous material. A 70 aged woman presented with 2-year history of progressive hip joint pain with osteoarthritis. No history of trauma was presented. Hip joint motion was moderately limited & radiographically, they presented a lucent area with sclerotic margin within the femoral head that was deformed and severe hip joint degenerative change. Treatment was consist of total hip replacement arthroplasty, because of severe hip joint osteoarthritis.
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외측 4개 중족 족지 관절의 골절-탈구 - 증례보고 -
임수재,Yim, Soo-Jae 대한족부족관절학회 2000 대한족부족관절학회지 Vol.4 No.1
Fracture and dislocation of the four lateral metatarsal head and neck at the metatarsophalangeal joint, which may be associated with a hyperextension force, axial load, and additional rotating force, has rarely been reported. The patient was a 32-year-old man who sustained the injury in a motor vehicle accident. Manual reduction was easily performed but maintenance of reduction was difficult, due to the associated fractures of the metatarsal necks. Thus percutaneous internal fixation with Kirshner's wires was required.
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대퇴골 경부 골절 불유합의 압박 동종 해면골이식술 및 대퇴방형근육경 골이식술
임수재,우승한 대한골절학회 2002 대한골절학회지 Vol.15 No.4
목적 : 대퇴골 경부 골절 불유합의 치료로서, 골흡수 부위의 압박 동종골 이식술 및 대퇴방형근육경골이식술을 시행하여 임상적 치료의 경험을 보고하고자 한다. 대상 및 방법 : 1998년 3월부터 1999년 4월 까지 대퇴경부의 골절 환자 중, 비관혈적 도수정복 및 다발성 핀 삽입술을 시행 받은 후 발생한 불유합으로 인하여 본원에 내원한 5예의 환자를 대상으로 골흡수 부위의 압박 동종골 이식술 및 대퇴방형근육경 골이식술을 시행하였다. 주시기간은 36개월에서 48개월이었으며 평균 추시 기간은 40개월 이었다. 추시 결과의 분석은 Lunceford 등의 평가와 방사선학적 검사를 3개월 간격으로 시행하여 골유합 여부를 확인하였다. 결과 : 36개월에서 48개월동안 관찰결과 모든 예에서 성공적인 골유합을 얻을 수 있었다. 또한 술후 4예에서 모두 14주에, 나머지 1예에서 6개월에 방사선상 골유합의 진행소견을 보여주고 있으며 수술 18개월후 방사선상 추시에서 완전한 골유합을 보이고 있었으며 임상적결과 또한 모두 우수 한 결과를 보여주고 있었다. 결론 : 대퇴경부골절 불유합의 치료로서 골흡수 부위의 압박 동종골 이식술 및 대퇴방형근육경 골이식술을 시행하는 술식은 골다공증이 상대적으로 심하지 않은 연령대에서, 대퇴골두를 보존하는 장점이 있어 대퇴골 경부골절 불유합을 치료하는 수술중 하나가 될 수 있을 것이다. Purpose : The aim of this study was attempted to evaluate the effects of impacted cancellous allograft and quadratus femoris pedicle bone graft in the management of nonunion of femur neck fracture. Materials and Methods : Between March 1998 and April 1999, 5 patients, rating from 36 to 45 years of age, were treated with impacted cancellous allograft and quadratus femoris pedicle bone graft and all cases were nonunion with closed reduction and multiple pinning. The duration of follow-up was from 36 months to 48 months and the mean follow-up period was 40 months. Clinical evalution was done according to Lunceford functional results and radiologically bone union was evaluated by 3 monthly X-ray check. Results : After follow-up from 36 months to 48 months, all cases resulted in the bone union. Four cases, radiologically bone union was progressed during 14 weeks, and the other, obtained at 6 months. All cases, at 18 months, radiologically complaints pain and instability. Conclusion : For patients with nonunion of femoral neck ftacture, impacted cancellous allograft and quadratus femoris pedicle bone graft was provide a good result of union.
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Duracon^(®) 인공슬관절을 이용한 슬관절 전치환술
임수재,박철수 순천향의학연구소 2005 Journal of Soonchunhyang Medical Science Vol.11 No.1
Purpose : The management of patella in total knee arthroplasty is still problematic. The purpose of this study was to evaluate the changes of clinical and radiological results after total knee arthroplasty without patellar resurfacing. Materials and Methods : We retrospective evaluated the nonresurfaced patella in 50 knees(65 patients) at an average of 77.5 months after total knee arthroplasty(Duracon^(®), Howmedica, Rutherford, NJ). Patients were diagnosed as osteoarthritis in 45 and rheumatoid arthritis in 3 and the others were osteonecrosis , and evaluated using the knee society knee score and functional knee score, modified patellar score. Results : The mean preoperative knee society knee score in osteoarthritis and rheumatoid arthritis were 58.2 and 36.7 points, and functional score were 35.8 and 34 points. The mean postoperative knee society knee score in osteoarthritis and rheumatoid arthritis were 95.5 and 93.2 points, and functional score were 75.2 and 83 points and the mean modified patellar score was 28.5 points, and 26 cases(52%) were excellent(30 35 points, 18 cases(36%) were good(25 29 points) and 6 cases(12%) were fair(20 24 points). There were no patella associated complications and in 8 cases(16%) of anterior knee pain which resolved with conservative treatment at latest follow up. Conclusion : Total knee arthroplasty with patelloplasty, without patellar resurfacing , provided satisfactory results without significant problems, and can avoid the complications (patellar dislocation and subluxation, fracture and component loosening, rupture of patellar and quadriceps tendon). But long term radiological and clinical follow up is recommended.
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임수재,제한웅 순천향의학연구소 2005 Journal of Soonchunhyang Medical Science Vol.11 No.1
Purpose : This paper studies characteristics, occurrence types, radiographs, MRI(magnetic resonance imaging), and histopathologic findings of femur neck fracture following avascular necrosis of the femoral head. Materials and Methods : The subjects of this study are femur neck fracture following avascular necrosis of the femoral head occurring in 7 cases of 7 Patients with osteonecrosis of femoral head among 130 cases of 68 patients who were treated at our hospital from March 2001 to March 2005, and analyzed though plain radiography finding, MRI, and histopathologic test. Results : All 7 cases were found of osteonecrosis of the bilateral femoral head, and most of avascular necrosis in parts of femoral neck fracture had invaded entire femoral head. Simple radiographic findings were 1 case of stage Ⅱ, 4 case of stage Ⅲ, and 2 cases of stage Ⅳ according to the Ficat and Alert classifications, MRI finding included 5 cases of class C, 2 cases of class D according to the Mitchell classification, and all cases found lesions of low signal intensity in T1W1, high signal intensity in T2W2, and other parts. The 1 case of histopathologic test developed femur neck fracture between the necrotic zone and the reparative zone. The form of femoral head fracture includes 5 case of type A, and 2 case of type B according to the Usui classification Conclusion : A spontaneous femur neck fracture can occur without any special exterior force between the necrotic zone and reparative zone in case invaded with wide range of osteonecrosis of the femoral head.
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