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- 저자 : 황득수(Deuk Soo Hwang) (검색결과 113 건)
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아킬레스건 파열의 수술적치료 -단단 봉합술 및 건외막피복술-
황득수,이원석,김경천,Hwang Deuk-Soo,Lee Won-Seok,Kim Kyung-Cheon 대한정형외과스포츠의학회 2002 대한정형외과스포츠의학회지 Vol.1 No.2
Purpose: To evaluate the results and prognosis of operative repair to acute rupture of achilles tend on associated sports injury. Materials and Methods: 21 cases were surgically treated and average follow-up period was 1 year and eight months. The forth decade was most common with $55\%$ and soccer was most common in sports with 5 cases. End-to-end suture of ruptured achilles tendon was performed, and paratendinous structure was wrapped sufficiently. Postoperatively. ankle was plantarflexed for 6 weeks with longleg cast. And then 2 weeks interval, short leg cast with equinous position was conversed to functional position. About 10 weeks after operation, ankle was recovered to right angle. Hooker scale was used to evaluate the results. Results: Compared to normal side, heel-floor distance of ruptures side was decreased 0.7 cm in average, and 0.8 cm was deceased after 20 times weight loaded dorsiflexion. Mid-calf circumference was deceased 0.3 cm, and active dorsiflexion and plantar flexion of ankle was decreased each 3 and 5degree. 16 cases showed ‘excellent’result and 5 cases showed ‘satisfactory’. There was no complication, such as re-rupture or infection at operation site. Conclusion: After end-to-end operative repair to achilles tendon, sufficient wrapping of paratendinous structure is efficient for healing and prevention of postoperative adhesion. And serial dorsiflex-ion cast change is considered to be a successful treatment for preventing residual equinus deformity.
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황득수,이광진,권육상,Hwang Deuk-Soo,Rhee Kwang-Jin,Kwon Youk-Sang 대한정형외과스포츠의학회 2002 대한정형외과스포츠의학회지 Vol.1 No.1
목적: 스포츠손상에의한비구순파열환자에서진단및치료에대해고찰해보고자하였다. 대상및방법: 1995년3월부터2000년1월까지스포츠손상후발생한고관절통으로본원에내원한환자에서비구순파열로진단된15예를대상으로하였다. 원인별로달리기5예, 격투기3예, 에어로빅3예, 수영2예, 등산1예, 자전거 1예등이었다. 남자가6명, 여자가9명이었고, 나이는 평균41세였다. 모든 환자는6개월간격으로 추시하였고, 보존적 치료를 시행한 경우최소2년 이상 투약 및 증세관찰을 하였고, 관절경적 수술을 시행한6예에서 수술 전, 수술 후 6개월과 12개월에 Harris Hip Score (이하HHS)를측정하였고, JOA pain scoring system에의해결과를평가하였다. 결과: 보존적치료를 시행한9예에서 HHS는 평균 15점 향상되었고, 그중 4예는 1단계의 통증 지수 향상이 있었는데, 이들 모두Czerny 분류상type IA였다. 관절경적수술을 시행한6예에서수술후 HHS는 32점향상되었고, 6예모두에서2단계이상의통증지수향상이관찰되었다.결론: 스포츠손상환자에서급,만성고관절통을호소하는경우비구순파열은반드시감별진단되어야하며, 이학적검사상의심이될경우자기공명관절조영술을이용한진단이유용할것으로사료된다. 확진이된경우관절경을이용한파열된비구순의변연절제술이효과적인치료방법으로생각된다.
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실패한 시멘트형 및 무시멘트형 인공고관절 대퇴스템으로부터 추출한 마멸입자에 대한 분석
황득수,Arun S. Shanbhag,Hallum O. Bailey,Harry E. Rubash (Deuk Soo Hwang) 대한고관절학회 1995 Hip and Pelvis Vol.7 No.2
Macrophages and giant cells activated by particulate debris play an important role in osteolysis and aseptic loosening of prosthetic hip components. Histological amd chemical analysis of interface membrane retrieved from failed hip prostheses have demonstrated that a large number of polyethylene( PE ) particles induce a major inflammatory reaction by activating macrophages. But, there were still debatable reports concerning inflammatory reaction between cemented and cementless hip prostheses. The objective of this study was to isolate particles from failed cemented and cementless hip prostheses interface membranes and characterize their morphology using Scanning Electron Microscopy (SEM). We obtained 18 interface membrane from failed femoral components(11; cementless, 7; cemened). Tissues were digested using a papain buffer and then hydrolysed using 4M KOH. After several washing and centrifugation, particles were extracted and seperated using a established protocol in which suspected PE debris is retrieved from a ethanol-hexane interface and suspended in ethanol prior to analysis. A SEM in conjunction with an Energy Dispersive x-ray(EDX) spectroscopy unit was used to conduct elemental and morphologic analysis: PE particles were variable; small rounded(mostly submicron sized, 98%) and its agglomeration with variable size up to 15 u were dispersed on whole fields. More larger irregular flake shaped particles ranged from 9-18 u were seen sparsely. Sometimes, elongated thick beaded or scale like(2-3 u) and thin fibrils were seen. We couldn't find any significant differences in morphology of PE particle(ie, shape, size and distribution) between cemented and cementless hip prostheses. It was very difficult to detect metal particles in which only 2 Titanum particles were found, suggesting further analysis is necessary. We also characterized cement(PMMA, Barium), bone and ather contaminant particles.
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황득수(Deuk Soo Hwang),이광진(Kwang Jin Rhee),이준규(June Kyu Lee),양준영(Jun Young Yang),변기용(Ki Yong Byun),전택수(Taek Soo Jeon) 대한골절학회 2000 대한골절학회지 Vol.13 No.3
Purpose: To compare the outcome in patients who have popliteal artery injury associated with fracture and/or dislocation around the knee according to treatment option. Materials & Methods: We have reviewed fourteen cases of popliteal artery injury patients associated with fracture and/or dislocation injury around the knee who had visited at Chungnam National University Hospital from April 1997 to July 1999. Results: Combined skeletal injuries included fracture of distal femur, fracture of proximal tibia, and dislocation of the knee. Internal or external fixation was applied for skeletal injuries. We repaired the injured popliteal artery using end-to-end anastomosis (3 cases), interposed saphenous vein graft (9 cases), prosthetic vein graft (1 case), or thrombectomy alone (1 case). The amputation rate was 21 % (3 out of 14 patients). In limb salvage cases, we evaluated the function of knee joint, and the results were as follows: good 5 cases, fair 3 cases, and poor 3 cases. Conclusion: Early diagnosis and prompt management for injuries of the popliteal artery is the most important factor to save the limb. Also, complete resection of all injured portion of vessel and reconstruction of patency through interposed saphenous vein graft are most useful method.
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전위성 관절내 종골 골절에서 Bohler 각의 회복에 있어서 외부 견인 장치 ( External distractor ) 의 이용
황득수(Deuk Soo Hwang),이광진(Kwang Jin Rhee),이준규(June Kyu Lee),최정희(Jung Hee Choi) 대한골절학회 2000 대한골절학회지 Vol.13 No.2
Purpose: We had studied the results retrospectively in displaced intraarticular calcaneal fractures treated with internal fixation by screw for thalamic portion and percutaneous pinning by K-wire using minimal Ollier's lateral approach, so we had reported good results, but recovery of Bohler angle loss was difficult technically. So, we used intraoperative external distractor combined with previous our method. Materials and Methods: We analysed retrospectively Bohler angle and clinical results on 12 cases with calcaneal fracture, who underwent an operation for displaced intraarticular calcaneal fracture by using external distractor from January 1997 to August 1998. Bohler angles were measured at preoperative, postoperative and last follow-up X-ray. Surgical technique is through minimal Ollier's lateral approach, reduced and fixed with screw of displaced posterior facet and used intraoperative external distractor for restoring of depressed calcaneal tuberosity and then did percutaneous pinning with K-wire. Results: In the previous our reports, the mean preoperative and postoperative Bohler angle were-0.9。, 19.1。 each other and the mean recovery of Bohler angle was 20.1。. After we use the intraoperative external distractor, the mean preoperative and postoperative Bohler angle were 0.92。, 26.0。 each other and the mean recovery of Bohler angle is 26.9。. It is nearly normal range of Koreans Bohler angle(31.1±0.4). Also there is no complication such as intraoperative calcaneal tuberosity fracture and soft tissue injury(skin necrosis, neurovascular injury). Conclusion: We obtained enough restoration of Bohler angle to normal range by using our previous method combined with intraoperative external distractor.
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