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수근 주상골 단독 탈구 : 1례 보고 A Case Report
하대호,김상수,송정인 圓光大學校 醫科學硏究所 1999 圓光醫科學 Vol.15 No.1
Isolated dislocation of the carpal scaphoid is extremely rare. Case report of isolated and complete volar dislocation of the carpal scaphoid have been reported rarely. On examination, the wrist was moderately swollen and tender over its volar aspect. Radiographs showed isolated, complete volar dislocation of the scaphoid. It was realigned and stabilized following; open reduction with K-wire fixation. The patient had been got neurolysis due to median nerve compression symptom(carpal tunnel syndrome) after postoperative four weeks. At six weeks, the K-wires were removed and the patient was allowed to range of motion exercise. 20 months after injury, the wrist was asymptomatic and had a range of active motion without instability. There was no roentgenographic evidence of scapholunate dissociation or avascular necrosis.
Dual Onlay Graft 변법을 이용한 상완골 불유합의 치료
한홍준,하대호,송정인 대한골절학회 1998 대한골절학회지 Vol.11 No.3
There have been some difficulties in treatment of nonunion of the humeral shaft with osteoporosis. We report here the results on the treatment of nonunion with osteoporosis by using modified dual onlay graft method. The six cases among 34 nonunions of humeral shaft were operated by modified dual onlay graft. Initial treatments were applied one hanging arm cast, two plate fixations, three intramedullary nailings. In the 3 cases of them, we performed plate fixation and bone graft as secondary treatment. However, nonunion occurred with loosening of fixation. Modified dual onlay graft was applied from 6 to 36 months (average 12 months) after fracture of humerus. The proximal and distal humeral nonunion surface was made decorticated and flattened, and then reduction was performed. On the lateral side of nonunion site, 6 holes plate was fixed and on the medial side, fixed with 5-9 cm cortical bone which was harvested from proximal tibia. Cancellous bone graft was performed around nonunion area. Long arm splint was done for 2-4 weeks after operation. The union period was in the range of 3.5-6 months (average 4.9 months) in all six cases. Quicker bone union was achieved as the bone block got longer and the number of the fixation screw increased. We conclude that modified dual onlay graft method is the one of effective methods to treat nonunion of humeral shaft fracture with osteoporosis.