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P.T.C.결여형 혈우병관절염 1예 : Report a case
장주해,ㅣ정태성,문명상 최신의학사 1973 最新醫學 Vol.16 No.1
Hemophilia is a hereditary disease which is transmitted as a sex-linked recessive trait and characterized by clotting defect and hemorrhagic manifestations caused by deficiency of one of three plasma thromboplastin factors, such as antihemophilic globulin(A. H. G. ), plasma thromboplastin component (P. T. C.) and plasma thromboplastin antecedent(P. T. A.). Repeated hemorrhage to the joint produce irreversible tissue changes which are essentially hyperpl?astic; secondarily, the pain produced by these changes causes joint contracture and muscle atrophy. This, 10 years old boy, had frequent bleeding episodes after minor trauma, and limitation of motion and some deformities of the both knees. Plasma thromboplastin component deficiency hemophilia was diagnosed by impaired prothrombin utilization and Rosenthal test. Treatment for this patient was consisted of aspiration of the involved joints, application of elastic bandage and splint.
경골 간부 제3형 개방성 광범위 분쇄골절 : Ilizarov 기구 외고정 4례 4 Case Treated by Ilizarov External Fixator
장주해 대한골절학회 1994 대한골절학회지 Vol.7 No.2
It is extremely diffcult to treat to the type g open fractures of the tibial shaft which have been severely comminuted and splitted in the long length. Early internal fixation with plates and screws or intramedullary nailing of type III open fracture is contraindicated because of high infection rate and circulatory compromising at the fracture site. External fixation is the method of choice for the treatment of type III open fracture of the tibia. It reduces the risk of infection and pennits easy access for wound care, early mobilization of joints and weight bearing. Four type g open fractures of the tibial shaft that were very unstable had entered this hospital from November 1990 to June 1992. The patients were all young males. The causes of injury were one explosion and three motor vehicle accidents. The open fractures were three type III A and one type IIIB according to Gustilos classification. These fractures were stabilized with IlIzarov external fixator. Parenteral antibiotic therapy was started from the emergency room to prevent infection. Illzarov fixator was applied 17 to 63 days(av. 37 days) after injury and maintained for 6 to 12 months(av. 8 months). Subsequent autogenous bone grafting and internal fixation were done in three patients 7 to 8 months after external fixation because of delayed union. Follow-up period ranged from 1 year and 11 months to 2 years and 6 months(av. 2 years and 2 months). Solid union was obtained in all patients between 1 year I month and 1 year and 7 months(av, 1 year and 3 months) without active osteomyelitis. At last follow-up, there were mild limitation of ankle joint motion in all patients and tibial shortening of 18 to 34mm(av. 25 mm)on the roentgenograms of three patients. No significant walking disability or malalignment of the leg was noted in all patients. The final results were very good compared to the severity of their injuries.