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황득수,진영안 충남대학교 의과대학 지역사회의학연구소 1990 충남의대잡지 Vol.17 No.2
It is generally agreed the best clinical results in treatment of injuries of the ankle are obtaind by anatomical restoration of the joint. For objective measurements of tibiotalar joint, some investigators used different criteria and defined the specific reference points under variable angle of internal rotation Ant- Post. Projection. But, occasionally we didn't acquire the accurate roentgenographic finding that was suggested by investigators. so, we check the varible angle of internal rotation film in addition to angle suggestion by investigators and compare the criteria between them. 1. There was no significant difference to measure the accuracy of medial clear space in according to variable rotation angle. 2. The overlapping distance of tibiofibula syndesmosis decreased by increasing internal rotation angle, but was not under 1mm(ie, index of injury) 3. To measure the weber's 3 criteria, we need to check the variable internal rotation ankle, if necessary. 4. We acquired the normal range of measurement about Tile's 2 criteria by variable internal rotation angle.
족관절 골절의 분류 : 분류체계간의 비교 Comparison Among the Sysytems
황득수,진영안 충남대학교 의과대학 지역사회의학연구소 1989 충남의대잡지 Vol.16 No.2
The main purpose of a classification system is to provide a mental picture of the injury and also information as to treatment a prognosis. At present, Lauge-Hansen classfication has improved the results of conservative treatment, and Danis-Weber classification which was taken by the AO(ASIF) group was designed for application to operative treatment. But, both system have dificiencies, Recently, the proposed classification system by M. Tile which was based on the ankle stability was interesting. So, compared among the system for identification that these systems are synonymous or if not, one system has a distinct advantage over the other. Total 135 patients, 135 cases have been reviewed at CNUH from January, 1983 to December, 1988. The results were as follows: 1. We considered that it was very difficult to classify the ankle fractures by Lauge-Hansen system because of complexity and variable fracture patterns. But, we have been classified the fractures abut 98.5% by simplification of medial malleolar frecture patterns. 2. Danis-Weber classification was simple and easily applicated, but it was not helpful for decision of the amount of injury, treatment and prognosis. 3. The proposed M. Tile classification added to a aspect of the stability, so it was helpful for descision of the treatment methods. Also, this system classified the isolate medial malleolar freature that was not by Danis-Weber classification. 4. From the above results, we consider that by Lauge-Hansen classification, can be identify the occult ligament injuries, and by M. Tile classification, deside the treatment methods.
이광진,황득수,진영안 대한골절학회 1991 대한골절학회지 Vol.4 No.1
The ankle is a complex weight-bearing joint and play an important role biomechanically. The injuries to the ankle joint complex include not only injuries that cause disruption of the bony architecture of the ankle joint but often significant ligamentous and soft tissue components. There is many study for ankle to exact diagnosis and treatment in order to anatomical reduction and stability. The author analysed 105 cases(102 patients) of ankle fracture which were admitted and treated in Orthopedic Department Chungnam National University Hospital from September 1985 to February 1990. The follwing results were obtained. l. According to classification, the most common fracture type was supinaton-external rotation type(33%) in Lauge-Hansen., type B (46%) in DanisWeber., type II unstable (50%) in Tile. 2. Among the three fracture classification, Lauge-Hansen classification is cumbersome and difficult to apply clinically because of complexity and variable fracture patterns but useful for hidden ligament injury. Danis-Weber classification is simple and easily applicated but not helpful for decision of the treatment methods. 3. According to Tile classification, bony avulsion fracture suggested posterior syndesmotic ligament complex injury was noted 26 cases (50%) in type II unstable with operative treatment. 4. Poor cases on clinical result were due to no achieving anatomical reduction and severe initial injury regardless of operative or conservative management.