전족부에 발생한 골격외 점액양 연골육종 - 1례 보고 -

서진수,조진호,김진환,박성혜,Suh, Jin-Soo,Cho, Jin-Ho,Kim, Jin-Hwan,Park, Seong-Hye 대한족부족관절학회 2002 대한족부족관절학회지 Vol.6 No.1

Extraskeletal myxoid chondrosarcoma is an unusual soft tissue sarcoma with distinctive histologic features. It once was called chordoid sarcoma because it resembles chordoma histologically. The lesion has been shown to be of chondroblastic origin. This lesion shown to have ultrastructural and molecular features distinct from that of myxoid chondrosarcoma of bone. We report a case of extraskeletal myxoid chondrosarcoma in forefoot.

족관절에 생긴 활액막성 연골종증

서진수,김지훈,김종인,김한성,Suh, Jin-Soo,Kim, Ji-Hoon,Kim, Jong-In,Kim, Han-Seong 대한족부족관절학회 2009 대한족부족관절학회지 Vol.13 No.1

Purpose: We evaluated the results of treatment and clinical symptoms of 11 cases of synovial chondromatosis in the ankle joint. Material and Method: From February 2001 to May 2008, 11 cases with synovial chondromatosis involving ankle joint underwent surgical treatment. There were 5 males and 6 females. The average age at surgery was 51 years. The average follow-up period was 42 months. Duration from onset of symptom to treatment was 117 months. Chief complaints of patients, 9 cases were pain and 1 case was mass like lesion, 1 case was found on x-ray. Preoperatively, all cases were evaluated on simple x-ray, 4 cases on CT, 4 cases on MRI and 1 case on ultrasonogram. 10 cases underwent synovectomy and loose body removal. 5 cases of 10 cases underwent open synovectomy and loose body removal and arthrosocpic surgery. 4 cases of 10 cases underwent only open synovectomy and loose body removal and 1 case of 10 cases underwent only arthroscopic surgery. 1 case underwent tibiotalar arthrodesis. Results: The location of loose bodies was 7 cases on posterior and 4 cases on anterior and 4 case on lateral and 3 cases on multiple site. Postoperatively, all patients showed marked clinical improvement and had subjective satisfaction except reoperation 2 cases and arthrodesis 1 case. AOFAS score of all patients was average 82.2. Conclusion: Clinical results of the synovial chondromatosis of ankle joint were satisfactory. More accurate preoperative evaluation is required to achieve prevention of postoperative recurrence and better outcome.

재발된 신경내 결절종에 의한 비골신경마비 - 1례 보고 -

서진수,Suh, Jin-Soo 대한족부족관절학회 2002 대한족부족관절학회지 Vol.6 No.2

A case of a peroneal nerve palsy caused by repeatedly recurred intraneural ganglion cyst is presented. A 19 year old male suffered from tingling sensation on the foot dorsum more than one year and underwent two times of mass excision and nerve palsy was recorvered. But it was recurred once more after 10 months after the second excision. The mass was located in the fibro-osseous tunnel against the fibular neck and the origin of the peroneus longus. The third complete excision was done and full recovery was obtained in 6 months.

소아에서 발생한 아킬레스건의 골화증 - 증례보고 -

서진수,김진환,주석규,Suh, Jin-Soo,Kim, Jin-Hwan,Choo, Suk-Gyu 대한족부족관절학회 2002 대한족부족관절학회지 Vol.6 No.2

Ossification of the Achilles tendon is a rare condition to be distinguished from the more frequently occuring tendon calcification. It is characterized by the presence of an ossific mass contained within the fibrocartilaginous substance of the tendon and is usually associated with prior surgery or trauma to the tendon. We treated a 13 year old girl with ossification of the Achilles tendon after sprain-like injury. We excised it one year later and the microscopic finding of the extirpated bony mass revealed fully maturated lamellar bone.

제5 중족골 기저부 골절의 수술적 치료

서진수,김정훈,최준영,Suh, Jin-Soo,Kim, Jung-Hoon,Choi, Jun-Young 대한족부족관절학회 2008 대한족부족관절학회지 Vol.12 No.2

Purpose: Nonunions and delayed unions are possible complications of fractures of fifth metatarsal base. We tried to report the results of the surgical treatment, which is not prevalent yet. Materials and Methods: Retrospective study of thirty nine patients undergoing operation at our institution between 2003 and 2008 was conducted. Six patients were excluded with loss of follow up before bony union, multiple trauma, pediatric fractures, stress fracture, open fracture. There were 18 males and 15 females with 45.1 years old mean age. The average follow-up period was 18.3 months. We used a midfoot scoring system of AOFAS for clinical assessment and radiologic findings to evaluate bony union, alignment. Results: According to Lawrence's classification, Zone 1 fractures were thirteen and Zone 2 were twenty. Average AOFAS score was 93.61. Conclusion: Early operative treatment with cannulated screw fixation in fractures of the fifth metatarsal base is thought to be an useful and easy treatment option with faster rates of union.

매우 불안정한 족관절 골관절병증에서 지주형태 자가 비골을 이용한 관절유합술(1예 보고)

서진수,정현욱,이우천,문정석,최준영,Suh, Jin-Soo,Chung, Hyun-Wook,Lee, Woo-Chun,Moon, Jeong-Seok,Choi, Jun-Young 대한족부족관절학회 2009 대한족부족관절학회지 Vol.13 No.1

Charcot arthropathy of the foot and ankle is characterized by a combination of sensory, motor and autonomic peripheral neuropathy leading to gross swelling, bony destruction and finally severe bony deformity with joint instability. We report a case of very unstable Charcot arthropathy in ankle joint managed with ankle arthrodesis using fibular strut bone grafting technique.

제1 중족족지 관절의 활액막 연골종증 (1예 보고)

서진수,김동현,Suh, Jin-Soo,Kim, Dong-Hyun 대한족부족관절학회 2007 대한족부족관절학회지 Vol.11 No.1

Synovial chondromatosis is an uncommon non-neoplastic condition of the joints, forming multiple cartilaginous nodules in the synovium. The lesion usually tends to involve large joints, and the occurrence in the small joint of foot is very rare. We would like to report a case of synovial chondromatosis which was confused with Freiberg infarction in the 1st metatarsophalangeal joint of the foot.

거골하 관절경술

서진수,Suh, Jin-Soo 대한족부족관절학회 2012 대한족부족관절학회지 Vol.16 No.1

The subtalar joint is a complex joint that is functionally responsible for inversion and eversion of the hindfoot. Advances in optical technology and surgical instrumentation have allowed the arthorscocpic surgeon to investiagate the small joints including the subtalar joint. Indications for subtalar arthroscopy include pain, swelling, stiffness and locking. Therapeutic indications include treatment of chondromalacia, osteophytes, arthrofibrosis, synovitis, loose bodies, osteochondral lesions, excision of a painful os trigonum, arthrodesis, and FHL tendinopathy. Contraindications to subtalar arthroscopy include infection, advanced osteoarthritis with deformity, severe edema, poor vascularity and poor skin quality. Subtalar arthroscopy is a technically demanding and difficult procedure that should only be performed by experienced surgeons. With proper instrumentation and careful operative techniques, satisfactory results may be obtained with minimal morbidity.

족관절 인공관절 치환술 후 족관절 운동범위의 변화

서진수,Suh, Jin-Soo,Saltzman, Charles L. 대한족부족관절학회 2006 대한족부족관절학회지 Vol.10 No.1

Purpose: Ankle fusion that is operated on severe ankle arthritis has its weakness in that normal walking is impossible, even though the result is pretty good. As a alternative choice, total ankle replacement pursues the longer survivorship with material improvement. However, it is not yet known how much range of motion is possible after the replacement, or how it has changed overtime. Therefore, we need an analyzation for that. Materials and Methods: A retrospective review of sixty-seven patients undergoing STAR total ankle replacement at our institution between 1998 and 2002 was conducted. Of those, twenty-six (39%) had complete sets of full dorsiflexion and plantar flexion lateral radiographs both between "immediate" postop and at a minimum of 2-years follow-up and no revision procedure during that time. The mean age of these patients was 63.2 years when the surgery was done; the etiology of arthrosis was 21(81%) post-traumatic/degenerative, 4 rheumatoid and 1 psoriatic. Results: Average "immediate" ankle range of motion was $15.9^{\circ}$, and total foot (non-ankle) motion was $20.6^{\circ}$. At one, two, and three years the average ankle and total foot ranges of motion were $17.4^{\circ}$, $17.6^{\circ}$, $15.6^{\circ}$ and $21.0^{\circ}$, $22.0^{\circ}$, $21.2^{\circ}$ respectively. Statistically there was no significant difference between "immediate" postop motion and one to three years postop (all p>0.05). Conclusion: The range of motion after the STAR total ankle replacement is maintained from the "immediate" postoperative range of motion, but not increased, in the 1-3 year post replacement period.

요골 원위부 골절 치료에서 잠김형 금속판 고정술과 일반 금속판 고정술의 정복소실에 관한 결과 비교

서진수 ( Jin Soo Suh ),이창수 ( Chang Soo Lee ),왕국현 ( Kook Hyun Wang ) 대한골절학회 2008 대한골절학회지 Vol.21 No.2

목적: 요골 원위부 골절 치료에서 잠김형 금속판과 일반 금속판을 이용해 치료한 예를 대상으로 환자의 임상적, 방사선학적 결과를 비교분석하고자 한다. 대상 및 방법: 2000년 1월부터 2006년 10월까지 요골 원위부 골절로 진단받아 잠김형 금속판 고정술을 시행받고 1년 이상 추시관찰이 가능한 환자 26예 및 일반 금속판을 이용하여 수술을 시행받은 환자 20예에 대해 각각 단순방사선학적 촬영을 이용해 추시 후 교정소실 정도를 비교하기 위한 수술 전, 후와 최종 추시상의 요골경사, 요골길이, 전방경사를 측정하였고 Mayo wrist score를 통한 기능적 평가를 통해 그 차이를 알아보았다. 결과: 잠김형 금속판 고정술 및 일반 금속판 고정술의 평균 추시관찰기간은 각각 13개월, 15개월이었으며, 골절 형태는 Frykmann 분류와 AO 분류를 이용하였다. 잠김형 금속판을 이용한 고정술에서 Frykmann 분류 제1형이 1예 (4%), 제2형이 2예 (8%), 제3형이 5예 (19%), 제4형이 14예 (54%), 제5형이 1예 (4%), 제7형이 2예 (8%), 제8형이 1예 (4%)였으며, AO 분류 A형이 4예 (15%), C형이 22예 (85%)였고, 일반 금속판에서 Frykmann 분류 제3형이 12예 (60%), 제4형이 4예 (20%), 제7형이 3예 (15%), 제8형이 1예 (5%)였으며, AO 분류 B형이 6예 (30%), C형이 14예 (70%)였다. 잠김형 금속판 고정술에서 수술 직후와 마지막 추시상에서 측정한 요골경사의 차이는 평균 1.03˚ 증가, 요골길이는 1.09 ㎜ 만큼 감소, 전방경사는 2.08˚ 감소하였고, 일반 금속판에서의 요골경사의 차이는 평균 2.4˚ 증가, 요골길이는 0.82 ㎜ 만큼 감소, 전방경사는 2.11˚ 감소한 것으로 측정되었으며 두 그룹 간에 통계적으로 유의한 차이 (p>0.05)를 보이지 않았다. 임상적 결과는 Mayo wrist score를 통한 기능적 평가에 따라 잠김형 금속판 고정술에서 우수 이상이 24예 (92%), 일반금속판에서 우수 이상이 17예 (85%)였다. 감염이나 지연유합 등의 합병증은 없었다. 결론: 요골 원위부 골절치료에서 잠김형 금속판 고정술과 일반 금속판 고정술을 비교해 보았을 때 요골경사, 요골길이, 전방경사의 차이 및 수술 후 기능적 평가는 초기 고정 후 정복의 소설이라는 측면에서 유의미한 차이를 보여주지 못했다. Purpose: The purpose of this study was to evaluate and compare the clinical & radiological outcome between LCP and conventional T-plate fixation in the treatment of distal radial fracture. Materials and Methods: From January 2000 to October 2006, 26 patients were treated by LCP fixation and 20 patients were treated by conventional T-plate fixation for distal radial fracture. We used the X-ray to calculate the radial inclination, radial length and volar tilting, then compared the loss of correction after the operation between both groups. We also evaluated the clinical functional outcome by Mayo wrist score. Results: The average follow-up since operation was ten months in both LCP and conventional T-plate fixation group. According to Frykmann classification, there were 1 case of type 1 (4%), 2 of type 2 (8%), 5 of type 3 (19%), 14 of type 4 (54%), 1 of type 5 (4%), 2 of type 7 (8%), 1 of type 8 (4%), and to AO classification, 4 of type A (15%), 22 of type C (85%) in LCP group. In conventional T-plate group, according to Frykmann classification, there were 12 cases of type 3 (60%), 4 of type 4 (20%), 3 of type 7 (15%), 1 of type 8 (5%), and to AO classification, 6 of type B (30%), 14 of type C (70%). In LCP group, the loss of correction between immediate post-operation and last follow-up was about 1.03° in radial inclination, -1.09 ㎜ in radial length, -2.08° in volar tilting at each, and in conventional T-plate group, 2.4° in radial inclination, -0.82 ㎜ in radial length, -2.11° in volar tilting at each. There was no statistical significance (p>0.05) in two groups. In the clinical functional outcome (according to Mayo wrist score), 92% of patient showed above good result in LCP group and 85% of patient showed above good result in conventional T-plate group. There was no infection, delayed union. Conclusion: There was no clinical & radiological difference between LCP and conventional T-plate fixation group in the radial inclination, radial length and volar tilting.