Locking Compression Plate를 이용한 전위성 쇄골 간부 골절의 수술적 치료

정남식,홍기도,하성식,박성준,강정호,심재천,Chung, Nam-Sik,Hong, Ki-Do,Ha, Sung-Sik,Park, Sung-Joon,Kang, Jung-Ho,Sim, Jae-Cheon 대한정형외과스포츠의학회 2006 대한정형외과스포츠의학회지 Vol.5 No.1

목적: 전위성 쇄골 간부 골절의 치료로 관혈적 정복술 후 LCP를 사용하여 내고정을 시행한 환자를 대상으로 방사선학적, 임상적 결과를 분석하여 전위성 쇄골 간부 골절의 치료에 있어서 LCP의 유용성을 알아보고자 하였다. 대상 및 방법: 2003년 5월부터 2004년 11월까지 본원에서 쇄골 간부 골절에 대해 LCP를 이용한 관혈적 정복, 금속내 고정술을 시행하고 6개월 이상 추시가 가능하였던 26례를 대상으로 하였다. 수술 후 최종 평가는 방사선 결과와 fang s criteria를 이용한 임상적 결과로 분석하였다. 결과: 수술 후 평균 9.3주에 모든 예에서 지연유합 없이 골유합 되었으며 임상적으로 Kangs criteria에 따라 구분한 결과, 우수 이 상이 22례로 나타났다. 특히, 견관절 운동은 상완골 골절이 동반된 두 경우를 제외한 24례에서 2.9주내에 정상 범위로 빠른 회복을 보였다. 합병증으로는 견관절 운동 장애 2례, 수술 절개 부위의 켈로이드 형성 1례였으며 그 이외에 다른 주요 합병증은 없었다. 결론: 전위성 쇄골 간부 골절에서 LCP를 이용한 관혈적 정복 및 금속내 고정술은 기존의 금속판에 비해 수술 후 합병증을 줄이고 효과적인 골유합과 조기 견관절 운동에 도움을 줄 수 있는 좋은 치료 방법 중 하나라고 사료된다. Purpose: To assess the effectiveness of the Locking compression plate (LCP) after open reduction for the treatment of the displaced clavicular shaft fracture, the clinical and radiologic outcome of the patients who were managed with the LCP for internal fixation after open reduction has been analyzed. Materials and Methods: We reviewed 26 cases with a displaced clavicular shaft fracture treated by internal fixation using Locking compression plate after open reduction between May 2003 and November 2004. The patients were followed up for at least six months period, and final postoperative outcome was evaluated using clinical results based on Kang's criteria, radiologic signs of fusion. Results: All fractures united by an average of 9.3 weeks without delayed union and showed fast recovery of motion fraction and shoulder function. In addition,24 cases without the fractures of proximal humerus recovered to normal range of shoulder notion within 2.9 weeks. Clinically, according to Kang's criteria, the outcome was good or better in 22 patients. The complications included shoulder joint dysfunction in two cases and keloid formation in one case, and no other complications were observed. Conclusion: The internal fixation using LCP for the treatment of displaced clavicular shaft fracture is a safe, reliable method of treatment, with few complications, and offers rapid recovery of shoulder joint function and bone union.

압박 고나사로 치료한 대퇴골 전자간부 골절의 고정 실패 인자에 대한 분석

정남식 ( Nam Sik Chung ),심재천 ( Jae Cheon Sim ),홍기도 ( Ki Do Hong ),하성식 ( Sung Sik Ha ),박성준 ( Sung Joon Park ) 대한고관절학회 2005 Hip and Pelvis Vol.17 No.4

목적: 대퇴골 전자간부 골절에서 압박고 나사를 이용한 수술적 치료후 발생할 수 있는 고정 실패에 영향을 미치는 인자에 대하여 분석하고자 하였다. 대상 및 방법: 1999년 1월부터 2003년 12월까지 대퇴골 전자간부 골절을 압박 고나사를 이용하여 치료하고 1년이상 추시가 가능하였던 73례를 대상으로 하였다. 이중 고정 실패는 11례였으며 성별 및 연령, 골절 양상, 골다공증, 나사의 골두 내 위치, 정복 양상 등 고정 실패에 관여할 것으로 기대되는 인자들을 통계학적으로 분석하였다. 결과: 성별 및 연령은 통계적인 차이를 보여주지 못했다(P>0.05). 골절 양상은 불안정성 여부가 고정 실패에 기여하는 유의한 인자로 나타났으며 Singh25) 지수를 이용한 골다공증을 기준으로 나눈 두 군에서도 의미있는 빈도 차이를 보여주었다(P<0.05). 대퇴골두 내 나사못이 상방에 위치한 경우와 골절의 수술적 정복후 전후면 방사선 사진상 5 mm 이상 전위된 경우에도 통계적인 차이를 보여주었다(P<0.05). 결론: 압박고 나사를 이용한 대퇴골 전자간부 골절의 치료에서 불안정성 골절, 심한 골다공증이 있는 경우 각별한 주의를 요하며 고정 실패를 방지하기 위해서는 정확한 정복이 필요하고 대퇴골두 내 압박 고나사의 상방 위치를 피하는 것이 좋을 것으로 사료된다. Purpose: To analyze the significant factors that may affect failure of fixation after surgical treatment of intertrochanteric fracture with compression hip screw. Materials and Methods: From January 1999 to December 2003, the authors analyzed 73 cases of trochanteric fracture of the femur treated with compression hip screw and followed for more than one year. There were eleven cases of failure of fixation. The relationship between the following factors was statistically analyzed: sex and age, fracture type, the degree of osteoporosis, placement of screw in femoral head, quality of reduction and failure of fixation. Results: Difference between age and sex were not statistically meaningful factor (P>0.05). The relationship between failure of fixation and unstable fracture was significant (P<0.05). There was a difference of prevalence between the two groups divided by the degree of osteoporosis using the Singh index (P<0.05). In the case of superior placement in the femoral head and displacement of the cortex of the proximal femur on radiologic AP view, there were more failures of fixation (P<0.05). Conclusion: More attention needs to be devoted to treatment in severe osteoporotic unstable intertrochanteric fracture. Accurate reduction and avoidance of the placement of the lag screw in the superior part of the femoral head were important factors to prevent failure of fixation in trochanteric fractures of the femur treated with the compression hip screw.

허혈성 심질환의 진단과 평가

정남식(Nam-Sik Chung) 한국항공우주의학협회 2000 항공우주의학회지 Vol.10 No.1

심장질환 11 예에 있어서 핵자기공명영상술 소견

정남식 ( Nam Sik Chung ),심원흠 ( Won Heum Shim ),장양수 ( Yang Soo Jang ),박금수 ( Kum Soo Park ),안창범 ( Chang Bum Ahn ),김윤수 ( Yoon Soo Kim ),조장희 ( Zang Hee Cho ) 대한내과학회 1985 대한내과학회지 Vol.29 No.4

남녀 및 나이에 따른 심자도 변수 차이 분석

임현균,정남식,이용호,권혁찬,정보영,박용기,Lim, Hyun-Kyoon,Chung, Nam-Sik,Lee, Yong-Ho,Kwon, Hyuk-Chan,Joung, Bo-Young,Park, Yong-Ki 대한의용생체공학회 2007 의공학회지 Vol.28 No.4

Magnetocardiography (MCG) is a device to measure the magnetic field from the heart. It is a noninvasive device and takes only few minutes to record magnetocardiogram from a subject. In this study, we compared the difference of MCG data recorded from 56 normal subjects in early twenties (28 males and 28 females, mean $age=21.0{\pm}1.6$ years) and 36 elderly subjects (20 males and 16 females, mean $age=61.9{\pm}6.9$ years) for the analysis of the age and gender difference. A total of 24 parameters used in the analysis were derived from QRS complex, R-wave, T-wave, and ST-T period. As a result, seven parameters including maximum current angle and map angle showed the significant difference (p<0.01 and p<0.05, respectively) between young males and young females. Significant difference (p<0.05) between elderly males and elderly females was found from a parameter, pole distance at T-wave peak. In the comparison of age difference, seven parameters regarding current moment, pole distance, and dynamics showed the significant difference between young and elderly males. Eight parameters also showed significant difference (p<0.05) between two younger and elderly female groups. Results showed that parameters regarding current moment, pole distance, and dynamics might be changed when people get older. In conclusion, gender and age difference should be considered when MCG data are analyzed for certain parameters.

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.

Locking Compression Plate를 이용한 원위 요골 골절의 치료

심재천 ( Jae Cheon Sim ),정남식 ( Nam Sik Chung ),홍기도 ( Ki Do Hong ),하성식 ( Sung Sik Ha ),강지훈 ( Ji Hoon Kang ) 대한골절학회 2005 대한골절학회지 Vol.18 No.2

심혈관 기능의 항공의학적 평가

김동수(Dong Soo Kim),정남식(Nam Sik Chung) 한국항공우주의학협회 1993 항공우주의학회지 Vol.3 No.1

CT Brain scan 을 이용한 뇌졸중의 감별진단

김기환 ( Ki Whan Kim ),정남식 ( Nam Sik Chung ) 대한내과학회 1980 대한내과학회지 Vol.23 No.7

족무지 신전 건에 발생한 건 내 결절종

홍기도(Ki-Do Hong),하성식(Sung-Sik Ha),정남식(Nam-Sik Chung),심재천(Jae-Cheon Sim),박성준(Sung-Joon Park),강정호(Jung-Ho Kang) 대한정형외과학회 2006 대한정형외과학회지 Vol.41 No.3

결절종은 가장 흔한 연부 조직 종양으로 알려져 있으나 건 내 결절종의 발생은 매우 드물며 그 원인 및 발생 기전은 아직 명확히 밝혀져 있지 않다. 52세 남자 환자가 우측 족배부에 무통성 종괴를 주소로 내원하였다. 저자들은 단 족무지 신전 건 내 결절종을 경험하고 수술적 가료로 만족할 만한 결과를 얻었기에 문헌 고찰과 함께 보고하는 바이다. A ganglion is the most common soft tissue tumor. But an intratendinous ganglion is a rare lesion of unknown etiology but with a natural history that originates within the tendon. A 52 year-old man complained of a palpable, non-tender mass in the dorsum of the right foot. We present a case of an intratendinous ganglion that developed in the extensor hallucis brevis tendon and which was treated successfully by excision.