당뇨병성 족부궤양의 재발과 연관된 위험인자: 심리사회적 위험인자를 포함한 후향적 연구

전숙하,손무원,배서영,Jeon, Suk-Ha,Sun, Mao-Yuan,Bae, Su-Young 대한족부족관절학회 2012 대한족부족관절학회지 Vol.16 No.2

Purpose: To evaluate several risk factors related to re-ulceration of diabetic foot including psychosocial aspects such as familial support and degree of independence of patients' activity. Materials and Methods: We reviewed medical records and performed telephone interview with eighty-five patients who had a history of hospitalization in our hospital due to diabetic foot ulceration from year 2002 to 2010. Based on the collected data, we analyzed several factors such as age, gender, prevalence duration, accompanying diseases, HbA1c level, degree of independence and familial support. Results: The mean age was 61.4 years and most common in the 4th decade. There were 57 cases (67%) of recurrence, predominance of male. Eleven patients with recurrent diabetic foot ulceration had undergone major amputations. Psychosocial problems such as depression, insufficient familial support and mortality were more frequently observed in recurrent group. Conclusion: This study shows that psychosocial factor such as familial support for patient with diabetic foot could be important to reduce the recurrence rate of diabetic foot ulceration. Therefore, we should pay attention to strategic plans for prevention, screening, treatment, and aftercare through the prospective studies including psychosocial risk factor in diabetic foot ulceration.

급성 족근과 골절 환자에서 시행한 컴퓨터 단층촬영 영상의 유용성

전숙하,배서영,안수형,정형진,우승훈,Jeon, Suk-Ha,Bae, Su-Young,Ahn, Soo-Hyung,Chung, Hyung-Jin,Woo, Seung-Hun 대한족부족관절학회 2015 대한족부족관절학회지 Vol.19 No.4

Purpose: We compared plain radiographs with computed tomography (CT) images to evaluate the usefulness of preoperative CT in acute ankle malleolar fracture in terms of accuracy of diagnosis and planning of operative strategy. Materials and Methods: A retrospective analysis was conducted on 210 cases of malleolar fracture treated at our institute for which plain radiograph and CT were obtained preoperatively. Observers had reviewed plain radiographs and recorded fracture classification, anatomical diagnosis, extent and configuration of fractures and then subsequently reviewed CT images. Records from each image were compared and information regarding the differences in fractures was assessed. Results: Fractures were notably changed in appearance in 88 cases (41.9%) and diagnosis changed in 30 cases (14.3%). According to the change of diagnosis and fracture appearances, the operative strategy was changed in 15 cases (7.1%) including incision, order of reduction, and target of fixation. Conclusion: CT could be a useful adjunctive imaging tool in addition to the plain radiograph in planning of operative treatment for acute malleolar fracture in terms of estimating exact configuration, extent of fractures and even newly revealed hidden fractures.

요골 간부 골절 치료 후 지연 발견된 원위 척골의 전방 탈구

전숙하(Suk Ha Jeon),이상림(Sanglim Lee) 대한정형외과학회 2021 대한정형외과학회지 Vol.56 No.5

원위 요척 관절의 전방 탈구 치료가 지연된 경우에는 수근부 통증과 전완의 회전 운동의 제한이 동반되어 결국 구제술이 필요한 퇴행성 관절염이 발생할 수 있다. 24세 남자가 요골 간부 골절 수술 후 통증과 회전 운동 제한으로 내원하였다. 금속판으로 고정된 요골의 간부에서 7도의 전방 각형성이 관찰되었으며 척골 두가 전방으로 탈구되어 회외전에서 결손부가 요골의 S자 절흔 전방 경계에 걸려 탈구가 지속되는 소견이 관찰되었다. 부정 유합된 요골의 교정의 절골술과 척골 두 골결손 근위부의 골을 원위 결손 부위로 이동시키는 절골술을 시행하여 원위 요척 관절이 전완의 회전에 안정적으로 정복이 유지되도록 하였다. 수술 후1 9개월에 전완 회전 운동 범위와 통증이 개선된 것을 확인하였다. Delayed treatment of volar dislocation of the distal radioulnar joint can result in wrist pain, limited rotation of the forearm, and degenerative arthritis that could be managed only by salvage procedures. A 24-year-old male patient presented with wrist pain and a loss of forearm rotation after surgery for a radial shaft fracture. The shaft of the radius was fixed with a plate and screws with a volar angulation of 7°. The ulnar head was dislocated volar to the distal radius, and the bone defect in the ulnar head was impacted into the volar rim of the sigmoid notch of the radius, preventing the head from being reduced in the joint. Corrective osteotomy of the malunited radial shaft and sliding osteotomy of the proximal ulnar head were performed to fill the distal bone defect. Pain and range of the forearm rotation were improved at postoperative 19 months.

전완부 양골 간부 골절의 치료 - 금속판 고정술과 Rush 핀 골수강내 고정술의 비교 -

박희곤,전숙하,변우섭,김명호,정홍근,전지용,유문집 대한골절학회 2006 대한골절학회지 Vol.19 No.2

전족부 거대신경초종: 증례 보고

서은석,이주한,전숙하,Seo, Eun-Seok,Lee, Joo-Han,Jeon, Suk-Ha 대한족부족관절학회 2014 대한족부족관절학회지 Vol.18 No.4

A schwannoma is a benign neurogenic tumor derived from Schwann cells. A rare case of a large painful schwannoma in the foot with metatarsal deformity was presented. Due to suspicion of malignancy, amputation had been recommended previously. We report on a rare case of a large forefoot schwannoma causing pain and paresthesia of the forefoot.

무지외반증에서 저상형 금속판 고정을 이용한 근위 개방형 절골술의 임상적 결과: 근위 갈매기형 절골술 후 K-강선 고정술과의 비교

서은석,방태정,전숙하,Seo, Eun-Seok,Bang, Tae-Jung,Jeon, Suk-Ha 대한족부족관절학회 2013 대한족부족관절학회지 Vol.17 No.4

Purpose: To present clinical results of proximal first metatarsal opening wedge osteotomy and low profile plate fixation in hallux valgus deformity. Materials and Methods: Thirty-two patients (39 feet) underwent surgery for hallux valgus deformity. Fourteen patients (18 feet; Group A) underwent proximal first metatarsal opening wedge osteotomy fixed with low profile titanium plate ($Arthrex^{(R)}$), and 18 patients (21 feet; Group B) underwent proximal chevron osteotomy with two K-wires. Improvement in hallux valgus angle (HVA), 1, 2 intermetatarsal angle (IMA), range of motion of 1st metatarsophalangeal joint, VAS score, and the length of first metatarsal on weight-bearing radiograph were evaluated preoperatively and at final follow-up. Results: HVA improved from $36.2{\pm}6.6$ degrees to $11.7{\pm}5.1$ degrees, and 1, 2 IMA improved from $15.7{\pm}2.6$ degrees to $7.2{\pm}1.9$ degrees. VAS score improved from $7.2{\pm}1.2$ to $1.4{\pm}0.9$. There were no significant differences clinically and radiologically. Conclusion: Proximal first metatarsal opening wedge osteotomy with stable fixation using low profile plate may be an effective surgical option for correction of hallux valgus deformity.

비매듭 금속 봉합 나사못을 이용한 관절경적 방카트 복원술: 임상적 및 방사선학적 결과의 비교

오정환,이상훈,박홍근,전숙하,박준석,김철기,박진영,Oh, Jung-Hwan,Lee, Sang-Hoon,Park, Hong-Keun,Jeon, Suk-Ha,Park, Joon-Suk,Kim, Cheol-Ki,Park, Jin-Young 대한정형외과스포츠의학회 2008 대한정형외과스포츠의학회지 Vol.7 No.2

목적: 비매듭 금속 봉합 나사못(knotless metal suture anchor)을 이용한 관절경적 방카트(Bankart) 복원술의 임상적 및 방사선학적 결과를 비교하였다. 대상 및 방법: 2001년 2월부터 2005년 1월까지 비매듭 봉합 나사못을 이용하여 관절경적 방카트 복원술을 시행하였고 1년 이상 추시 가능했던 68예를 대상으로 하였다. 술 후 평균 추시 기간은 34개월이었다. 평가는 Rowe score, 관절 운동 범위, 주관적 시각 척도(VAS)에 의한 통증 정도를 측정하였으며 수술 전 후 방사선학적 결과와 비교하였다. 결과: Rowe scoring system에서 술 전 43.3에서 술 후 95.6로 평가되었다. 관절운동범위는 최종 추시시 정상 팔에 비해서 거의 차이는 없었다. 주관적 시각 척도에 의한 통증의 정도는 술 전 3.3에서 술 후 0.5로 측정되었다. 방사성 저음영선은 약 15예에서 관찰되었다. 15예 중 2예에서 재탈구 및 나사못 관절병증으로 재수술을 시행하였고 Odds Ratio상 2.6배의 견관절 불안정성을 호소하였다. 결론: 비매듭 봉합 나사못을 이용한 방카트 복원술은 유용한 방법이나 외래 추시 중 나타나는 나사못 주위의 방사성 저음영선은 불량한 예후를 암시할 수 있기 때문에 주의가 필요하겠다. Purpose: To study the clinical and radiologic results with arthroscopic Bankart repair using knotless metal suture anchor. Materials and Methods: From February 2001 to January 2005, 68 patients, who underwent arthroscopic Bankart repair using knotless suture anchor and were followed up more than 12 months, were evaluated. A mean follow-up period was 34 months. All shoulders were evaluated by Rowe scoring system, range of motion of the shoulder, pain degree of VAS, and This was compared by radiologic findings after surgery. Results: The Rowe scoring system was 43.30 preoperatively, which improved to 95.55 postoperatively. At last follow-up, there was no significance difference between operated shoulder and non-operated shoulder in range of motion. The degree of VAS was measured from 3.3 preoperatively to 0.5 postoperatively. The radiolucent line was shown around suture anchor in 15 shoulders. 2 shoulders of 15 shoulders were reoperated due to redislocation and anchor arthropathy. In Odds ratio, this group (15 patients) had more 2.6 times the subjective instability than other group (53 patients). Conclusion: Arthroscopic Bankart repair using knotless anchor suture is very effective operative technique. But we have to be careful because the radiolucent line around anchor showed up during a follow -up period may indicate poor prognosis.

Knotless metal suture anchor를 이용한 관절경적 Bankart복원술

박진영,이상훈,박홍근,전숙하 대한견주관절의학회 2007 대한견주관절학회 학술대회논문집 Vol.2007 No.5

수근 관절의 만성 감염성 관절염에 대한 개방적 활막 절제술

이상림,신용운,손수인,전숙하 대한수부외과학회 2012 대한수부외과학회지 Vol.17 No.4

Purpose: We reported the results of open synovectomy for chronic infectious arthritis of the wrist. Methods: Fifteen patients who had chronic infectious arthritis of the wrist and underwent open synovectomy were reviewed retrospectively baesd on preoperative periods, symptoms, results of laboratory tests, radiological findings including magnetic resonance imaging (MRI), hospitalization period, and others. Pain scale and subjective satisfaction were checked by phone interview. Results: Average preoperative period was 96.1 days. Pain on motion and edema were observed in all cases. Four patients had positive bacterial cultures and three were identified as tuberculous infection. Signal changes of bones were observed in MRI of 10 patients. Osteomyelitis was found in 8 patients during the operation and bone resection or fusion should be performed in three. Average number of operation times was 1.53. Conclusion: When the patients show chronic swelling and pain on motion of the wrist, diagnostic work-ups for chronic infectious arthritis should be performed including arthrocentesis and MRI. Treatment including open synovectomy should be done immediately. 목적: 수근 관절에 발생한 만성 감염성 관절염 환자에서 개방적 활액막절제술을 시행한 결과를 보고하고자 한다. 대상 및 방법: 만성 감염성 관절염으로 개방성 활막 절제술을 시행받은 15명을 후향적 방법으로 이환 기간, 수술 전 증상,magnetic resonance imaging (MRI) 소견, 검사 결과, 평균 입원 기간 등을 조사하고, 전화 인터뷰를 시행하였다. 결과: 수술 전 이환 기간은 평균 96.1일이었고, 전 예에서 수근 관절의 부종과 운동 시 통증이 관찰되었다. 4예에서 일반세균이 동정되었고, 3예에서는 결핵 감염이 확인되었으며, 10예에서 MRI에서 골 신호의 변화가 관찰되었고, 8예에서 골수염이 확인되었다. 평균 1.53회의 수술을 시행하였고, 3예는 골 절제술, 관절 유합술을 시행하였다. 결론: 수근 관절의 만성 부종과 운동 시 통증이 있는 경우, 만성 감염성 관절염의 진단을 위해 관절천자와 MRI를 포함한적극적인 검사와 개방적 활막 절제술을 포함한 치료를 최대한 빨리 시행하는 것이 중요하다고 생각된다.

Comparison between Chronic Ulnar and Radial Collateral Ligament Repairs in the Metacarpophalangeal Joint of the Thumb

이상림,하지윤,김지영,전숙하 대한수부외과학회 2018 대한수부외과학회지 Vol.23 No.4

Purpose: Favorable results have been reported after the direct repair of chronic ulnar collateral ligament ruptures of the thumb metacarpophalangeal (MP) joint, but the results for radial ligament seem rather controversial. The purpose of this study is to compare the results of ligament reattachment between chronic rupture of the ulnar and the radial collateral ligament (RCL) of the joint. Methods: We reviewed retrospectively the radiologic and clinical results of ligament reattachment with suture anchors for chronic (more than 6 weeks) rupture of the collateral ligament of the thumb MP joint with averaged 22-month follow-up. The data between 6 radial and 8 ulnar ligament repairs were compared statistically. Results: The average of postoperative ulnar deviation angle was 13.3° in radial ligament and 2.0° in ulnar ligament (p=0.020) in the last follow-up plain X-ray. Postoperative ligament instability was positive in 4 out of the 6 radial repairs and no case with instability was observed in ulnar ligament. In postoperative follow-up, sustained joint subluxation was observed only in 2 out of the 6 radial repairs. Conclusion: The delayed repair of the RCL of the thumb MP joint resulted in less favorable outcomes and ligament insta-bility was observed postoperatively in more than half of the cases.