09-05 성열보(국)

Size: px
Start display at page:

Download "09-05 성열보(국)"

Transcription

1 ORIGINAL ARTICLE Print ISSN Online ISSN Traumatic Dislocation of the Hip with a Femoral Head Fracture Yerl-Bo Sung, MD, PhD, Jung-Yun Choi, MD, Jong-Woo Kim, MD Department of Orthopedic Surgery, Sang-Gye Paik Hospital, College of Medicine, Inje University, Seoul, Korea Purpose: This study was designed in order to evaluate the clinical results and frequency of complications of patients who underwent surgical treatment for traumatic dislocation of the hip with a femoral head fracture. Materials and Methods: Eighteen cases of Thompson-Epstein type V femoral head fracture with dislocation of the hip from November 2002 to November 2011 were analyzed retrospectively. We divided the cases into two groups according to availability of closed reduction and reduction time, and analyzed the clinical results according to Epstein criteria and frequency of avascular necrosis of the femoral head and posttraumatic osteoarthritis. Results: Among all patients, the observed complications included three cases of avascular necrosis and one case of posttraumatic osteoarthritis. The data showed that 14 cases were available for closed reduction; otherwise, there were four cases of failure. Significant differences were observed in clinical results and frequency of complications. Results regarding reduction time showed that 10 cases took 6 hours, and the other eight cases took more than 6 hours. There were no differences in clinical results, but, better results were achieved with a reduction time in 6 hours. However, significant differences were observed in frequency of complications. Conclusion: The availability of closed reduction would be an important factor for achievement of good clinical results in traumatic dislocation of the hip with a femoral head fracture. In order to obtain better clinical results, closed reduction should be performed as rapidly as possible. Key Words: Femoral head fracture, Dislocation of the hip, Thompson-Epstein type V Submitted: November 2, st revision: December 11, nd revision: January 9, rd revision: February 1, th revision: March 5, 2013 Final acceptance: March 5, 2013 Address reprint request to Yerl-Bo Sung, MD, PhD Department of Orthopedic Surgery, Sang-Gye Paik Hospital, College of Medicine, Inje University, Sang-Gye 7-dong, Nowon-gu, Seoul , Korea TEL: FAX: ybs58@paik.ac.kr 본논문의요지는 2012 년도대한정형외과학회추계학술대회에서발표되었음. 본논문은 2012 년도인제대학교학술연구조성비보조에의한것임. (This work was supported by the 2012 Inje University Research Grant) This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 서 론 외상성탈구는정형외과적응급상황으로이중외상성고관절후방탈구는약 5% 를차지하고있고, 대퇴골두의골절을동반하는경우가외상성고관절후방탈구의약 7% 를차지하고있다 1,2). 대퇴골두골절을동반한외상성고관절후방탈구는다른장기의동반손상이빈번할뿐아니라대퇴골두의무혈성괴사, 외상성관절염등합병증을초래할수있어수상초기에신속하고정확한처지와지속적인추시관찰이필요하다. 대퇴골두의골절은드문골절로이에대한임상결과와합병증에대한국내보고도부족한상황이며, 정복까지걸린시간과의연관성을비교분석한연구들도여전히논란의여지가있다. 따라서저자들은 Epstein 3) 기준을이용하여 Thompson-Epstein 4) 분류 V 형에해당하는환자중대퇴골두골절양상에따라 Pipkin 5) 의 Copyright c 2012 by Korean Hip Society 57

2 4 가지형으로분류하여도수정복가능여부및정복까지걸린시간에따라각각두군으로나누어서이에대해각각의임상결과와합병증발생빈도를알아보고자하였다. 대상및방법 2002 년 11 월부터 2011 년 11 월까지본원에내원한고관절후방탈구환자중대퇴골두골절이동반된 18 예를대상으로 1 년이상추시관찰하여의무기록과방사선기록을후향적으로검토하였다. 포함기준 (inclusion criteria) 은본원에서방사선학적검사및관혈적정복술을모두시행한환자였으며, 제외기준 (exclusion criteria) 은해부학적도수정복후안정성확보및골편의완전정복으로보존적치료를시행한환자였다. 총 18 예중남자가 11 명, 여자가 7 명이었고, 연령분포를보면수상당시연령은최소 17 세에서최대 85 세로평균 44 세였으며, 추시기간은최소 12 개월부터최대 122 개월까지평균 30.8 개월이었다. 수상원인으로교통사고가 13 예로대부분을차지하였고, 5 예에서추락사고에의해발생하였다. 교통사고중차량내부에탑승한상태에서발생한 10 예중 9 예는안전벨트를착용한운전자였고, 1 예는착용하지않은상태로뒷좌석에앉아있었으며, 오토바이탑승으로발생한경우가 3 예였다. 방사선학적측정은 Marosis M-view 5.4(Marotech, Seoul, Korea) 를이용하였으며, 골반골의전후면, 사면상, 입구상, 출구상단순방사선사진과컴퓨터단층촬영검사를분석하여 Thompson-Epstein 4) V형을 Pipkin 5) 분류에따라골절양상을나누었으며, I형이 4예, II형이 2예, IV형이 12예였다. 대퇴골두골절과동반된손상으로 Pipkin I형에서척추손상 1예, 편측대퇴경부골절 1예가있었으며, IV형중 3예에서동측의슬개골골절, 1예에서무릎의측부인대손상과중족골골절, 1예에서발목골절과다발성늑골골절, 1예에서두부손상과삼각골골절, 1예에서전완부골절, 1예에서좌골신경마비가있었다. 정복시기는도수정복이가능하였던 14예중본원에직접내원하여 Allis 6,7) 방법과 Stimpson 6,8) 방법을통해서정복을시행한경우가 12예, 타병원에서정복후전원된경우가 2예였으며, 도수정복이실패하여수술적정복을시행한경우가 4예였다. 정복까지걸린시간은 10예에서 6시간이내에정복을시행할수있었으며, 8예에서 6시간이후에정복을시행할수있었다. 수술접근법은관절경을이용한골편제거술을시행한 2 예를제외한 16예중대퇴골두에나사못고정술을시행한 4예에서는 flip osteotomy, 비구에내고정이필요한 12예에서 Kocher-Langenbeck 도달법을사용하였으며, 이중대퇴골두의내고정이추가로필요한 2예에서 Kocher- Langenbeck 도달법시행후 flip osteotomy를병행하였 Table 1. Criteria for Evaluating Clinical and Radiographic Results Clinical Radiographic Excellent No Pain Normal Relationship between Femoral Head and Acetabulum (All of the Full Range of Hip Motion Normal Articular Cartilage Space Following) No Limp Normal Density of the Head of the Femur No Spur Formation No Calcification in the Capsule Good No Pain Normal Relationship between Femoral Head and Acetabulum Free Motion Minimum Narrowing of the Cartilage Space (75% of Normal Hip) Minimum Deossification Slight Limp Minimum Spur Formation Minimum Capsular Calcification Fair Pain, but not Disabling Normal Relationship between Femoral Head and Acetabulum Limited Motion of Hip Moderate Narrowing of the Cartilage Space : No Adduction Deformity Mottling of the Femoral Head Moderate Limp Moderate Spur Formation Moderate to Severe Capsular Calcification Depression of the Subchondral Cortex of the Femoral Head Poor Disabling Pain Almost Complete Obliteration of the Cartilage Space Marked Limitation of Relative Increase in Density of the Femoral Head Hip Motion Subchondral Cyst Formation or Adduction Deformity Formation of Sequestra Redislocation Gross Deformity of the Femoral Head Severe Spur Formation Acetabular Sclerosis 58

3 Yerl-Bo Sung et al.: Traumatic Dislocation of the Hip with a Femoral Head Fracture 다. 제 1 저자가모든수술을집도하였고, 환자의추시는수술후 1 개월, 3 개월, 6 개월, 12 개월에하였으며, 그후는 1 년간격으로외래진료를통해서임상적및방사선학적평가를시행하였다. 골반과고관절의단순방사선사진을통해평가하고, 고관절동통및운동범위제한등의이상소견을보일때컴퓨터단층촬영을시행하였으며, 임상적평가에서대퇴골두의무혈성괴사가의심될때자기공명영상을시행하였다. 합병증으로는대퇴골두의무혈성괴사및외상성관절염발생유무에대해서평가하였다. 도수정복이가능한군 (Group R) 과도수정복이불가능한군 (Group NR) 두군으로나누어임상결과와합병증발생빈도를비교분석하였다. 또한, 도수정복까지걸린시간에따라 6 시간을기준으로 6 시간이내정복한군 (Group S) 과 6 시간이후정복한군 (Group L) 두군으로나누어임상결과와합병증발생빈도를비교분석하였다. 임상결과는 Epstein criteria 3,9) 에따라우수, 양호, 보통, 불량으로나누어평가를시행하였다 (Table 1). 통계학적분석은도수정복가능여부및정복까지걸린시간에따른임상결과, 합병증발생빈도, 성별및 Pipkin type 의연관성에대해피셔의정확검정 (Fisher`s exact test) 를사용하여검정하였고, 선형대선형결합법 (linear by linear association) 을이용하여경향성분석 (trend test) 를시행하였다. 나이차이에대해서는 t-test 를이용하였다. 통계분석은상용화된 SPSS 소프트웨어 (SPSS for Windows release 16.0, SPSS, Chicago, IL, USA) 를사용 하였고, P<0.05 일때유의한것으로정의하였다. 결 과 대퇴골두골절을동반한외상성탈구후도수정복이가능한군 (Group R) 은 14 예 ( 우수 5 예, 양호 7 예, 보통 2 예 ), 실패한군 (Group NR) 은 4 예 ( 보통 1 예, 불량 3 예 ) 로두군간에임상결과는유의한차이를보였으며 (P=0.002), 도수정복이가능할수록 Epstein 기준에따른임상결과가좋아지는경향이있었다 (P=0.001). 또한전체합병증발생빈도에서는유의한차이를보였고 (P=0.019), 도수정복이실패한 4 예모두합병증이발생하였다. 나이와성별에따른도수정복가능여부는통계학적으로유의한차이를보이지않았으며 (P=0.336, P=0.119), 대퇴골두골절양상에따라분류한 Pipkin type 역시유의한차이를보이지않았다 (P=0.540) (Table 2). 외상성고관절후방탈구에동반된대퇴골두골절의정복까지걸린시간은 6 시간이내 (Group S) 가 10 예 ( 우수 4 예, 양호 5 예, 보통 1 예 ), 6 시간이후 (Group L) 가 8 예 ( 우수 1 예, 양호 2 예, 보통 2 예, 불량 3 예 ) 로임상결과에서유의한차이를보이지않았으나 (P=0.151), 6 시간이내에대퇴골두의정복을시행할수록임상결과가좋아지는경향이있었다 (P=0.022). 또한, 전체합병증발생빈도에서는유의한차이를보였고 (P=0.023), 6 시간이내에도수정복을시행한 10 예서는합병증이발생하지않았다. 나이와성별 Table 2. Comparison of Clinical Results and the Complications between Group R and Group NR According to the Availability of Reduction Availability of Reduction Linear by linear Group R Group NR P-value Association (n=14) (n=4) (P-value) Age 46.9± ± Sex (Male/Female) 7/7 4/ Pipkin Type I (n=4) 4 (100) 0 (0)00 II (n=2). 2 (100) 0 (0)00 IV (n=12) 8 (67)0 4 (33)0 Clinical Result 0.002* 0.001* Excellent (n=5) 5 (100) 0 (0)00 Good (n=7) 7 (100) 0 (0)00.Fair (n=3) 2 (67)0 1 (33)0 Poor (n=3) 0 (0)00 3 (100) Complication 0.019* AVN (n=3)0 0 (0)00 3 (100). OA (n=1) 0 (0)00 1 (100) Group R were possible for the reduction, Group NR failed in the reduction. The values are given as the number of hips, with the percentage in parentheses. * Significant at P<0.05. P-value using Fisher s exact test. AVN: Avascular Necrosis of Femoral Head, OA: Post-traumatic Osteoarthritis. 59

4 Table 3. Comparison of Clinical Results and the Complications between Group S and Group L According to the Reduction Time Reduction Time (Hour) Linear by linear Group S Group L P-value Association (n=10) (n=8) (P-value) Age 47.8± ± Sex (Male/Female) 5/5 6/ Pipkin Type I (n=4) 3 (75) 1 (25) II (n=2). 02 (100) 0 (0)0 IV (n=12) 5 (42) 7 (58) Clinical Result * Excellent (n=5) 4 (80) 1 (20) Good (n=7) 5 (71) 2 (29).Fair (n=3) 1 (33) 2 (67) Poor (n=3) 0 (0)0 03 (100) Complication 0.023* AVN (n=3). 0 (0)0 03 (100) 0 OA (n=1) 0 (0)0 01 (100) Group S: Reduction time took in 6 hours, Group L: Reduction time took over 6 hours. The values are given as the number of hips, with the percentage in parentheses. * Significant at P<0.05. P-value using Fisher s exact test. AVN: Avascular Necrosis of Femoral Head, OA: Post-traumatic Osteoarthritis. A B C D Fig. 1. (A, B) A 23-year-old male sustained Pipkin type I fracture of hip. (C, D) Open reduction and internal fixation of femoral head with trochanter flip osteotomy was done. The radiograph and CT at postoperative 20 months shows complete healing of the fracture, and there is no evidence of avascular necrosis of femoral head or post-traumatic osteoarthritis. 60

5 Yerl-Bo Sung et al.: Traumatic Dislocation of the Hip with a Femoral Head Fracture 에따른대퇴골두골절의정복까지걸린시간은통계학적으로유의한차이를보이지않았으며 (P=0.429, P=0.367), 대퇴골두골절양상에따라분류한 Pipkin type 역시유의한차이를보이지않았다 (P=0.397) (Table 3). Pipkin I 형의경우 2 예에서는관절경을이용한골편제거술을시행하여우수의임상적결과를얻었다. 나사못고정술을시행한 2 예중 1 예에서는우수의임상적결과를얻었고 (Fig. 1), 척추손상과편측대퇴경부골절이동반된 1 예에서는양호의임상적결과를얻었으나수상후 3 개월만에침상낙상으로인공고관절반치환술을시행하였다. Pipkin II 형의경우 2 예에서모두나사못고정술을시행하여양호의임상적결과를얻었다. Pipkin IV 형의경우 2 예에서는후벽비구골절에대해서나사못고정술을시행하였고, 10 예에서는금속판고정을시행하여 6 예에서양호이상의임상적결과를얻었으며, 나머지 6 예에서보통이하의임상적결과를얻었다. 양호이상 6 예중 1 예에서는좌골신경손상이동반되었으며 12 개월추시관찰결과회복되었고, 비구에대해서금속판고정술을시행한후 2 개월후에재탈구가인지되어수상당시손상된연부조직으로인해전치환술을시행하면반복적인재탈구가우려되어반치환술을시행하고외래에서추시관찰중이다 (Fig. 2). 보 통이하 6 예중 1 예에서외상성관절염과 3 예에서대퇴골두의무혈성괴사가인지되어불량의임상적결과를얻었으며인공고관절치환술을시행하였다 (Table 4, Fig. 3). 고 찰 본연구는대퇴골두골절을동반한외상성탈구에서도수정복가능여부및정복까지걸린시간에따른임상결과및합병증발생빈도사이의연관성을알아보고자하였고, 도수정복이가능하며정복까지걸린시간이 6 시간이내로빠를수록임상결과가좋아지는경향을알수있었다. 또한, 조기에도수정복이실패한경우전체합병증발생빈도가높아진다는결과를얻었다. 고관절탈구의도수정복방법으로 Canale 6) 은 Stimson 6,8) 방법, Allis 6,7) 방법, Bigelow 6) 방법이있다고하였으며, 본연구에서는 Stimson 방법과 Allis 방법을이용하였다. Lyddon 등 10) 과 Gittins 등 11) 은고관절후방탈구에서정복시단외회전근, 비구골편, 손상된비구연등에의해방해된다고하였으며, 본연구에서는 4 예에서비구골편에의해도수정복이실패하였다. Pipkin 5) 은 Thompson-Epstein 4) 분류 V 형의후방탈구 A B C D E F G Fig. 2. (A, B) A 71-year-old male sustained Pipkin type IV fracture of hip. (C) Open reduction and internal fixation of acetabulum with spring plate and screws through the Kocher-Langenbeck approach was done. (D, E) The radiograph and CT at postoperative 2 months shows neglected posterior dislocation of hip. (F, G) Bipolar hemiarthroplasty of hip was done. The radiograph at postoperative 30 months shows well maintained prosthesis. 61

6 및골절을다시대퇴골두골절양상에따라 4 가지형태로분류하였으며 Stannard 등 12), Marchetti 등 13) 은 Pipkin IV 형이제일많다고보고하였으며, 본연구에서도 IV 형이 12 예로제일많이발생하였다. Stannard 등 12) 은도수정복을최대한빠르게하고골절편을해부학적으로정복및정확한고정이좋은결과를얻을수있다고하였고, 24 시간을기준으로조기에정복하는경우가더좋은결과를보인다고보고하였으나, Marchetti 등 13) 은도수정복을 6 시간기준으로비교분석한결과유의한차이점을얻지못하였다고보고하였다. 본연구에서는 24 시간이내에는대부분도수정복이이루어져서 6 시간을기준으로하여 6 시간이내가 10 예, 이후가 8 예있었으며임상결과를비교분석한결과역시유의한차이점을얻지못하였으나 6 시간이내로조기에정복을시행하면임상결과가좋아지는경향을알수있어추후더많은대상자를통한연구가필요할것으로사료된다. Epstein 등 15) 은고관절의후방탈구시발생하는합병증으로대퇴골두의무혈성괴사이외에관절연골, 관절낭, 인대등의손상으로외상성관절염이나, 좌골신경손상, 관절주위의이소성골화등을보고하였고, Pape 등 16) 은 손상초기에적극적으로치료하는것이합병증발생률을감소시켜좋은결과를얻을수있다고하였다. 국내연구를살펴보면 Kim 등 17) 은 10 예의대퇴골두골절에대해평균 33 개월간추시관찰하여 1 예의외상성관절염과 1 예의대퇴골두의무혈성괴사를보고하였으며, Park 등 18) 은 17 예의대퇴골두골절에대해 4 예의대퇴골두의무혈성괴사와 1 예의이소성골화증의합병증을보고하였다. 대퇴골두의무혈성괴사는자기공명영상촬영을통해서진단하고 Marchetti 등 13) 과 Kloen 등 19) 은 6% 에서 23% 까지보고하고있으며수상후 17 개월째에서 2 년까지잘발생한다고하였는데 1), 본연구에서도수상후추시 2 년동안에 3 예 (16.7%) 발생하여인공고관절치환술을시행하였다. Hougaard 등 20) 은대퇴골두의무혈성괴사의위험성이대퇴탈구로부터정복까지걸린시간이 6 시간이상지연될경우발생위험도가증가한다고하였으며, 본연구에서도 6 시간을기준으로전체합병증발생빈도에는유의한상관관계가있었으나대퇴골두의무혈성괴사의발생빈도는유의한차이를발견할수없었다. 외상성관절염에대해 Watson-Jones 14) 은수상당시손상정도및대퇴골두의체중부하부위에따라발생률을결 A B C D E F Fig. 3. (A, B) A 42-year-old male sustained Pipkin type IV fracture of hip. (C) Open reduction and internal fixation with reconstruction plate and screws through the Kocher-Langenbeck approach with trochanter flip osteotomy. (D) The radiograph at postoperative 21 months shows avascular necrosis of femoral head and osteoarthritis change on the joint. (E, F) Total hip arthroplasty was done. The radiograph at postoperative 96 months shows stable fixation of cup and stem. 62

7 Yerl-Bo Sung et al.: Traumatic Dislocation of the Hip with a Femoral Head Fracture 정하는데단순대퇴골두탈구보다는대퇴골두골절이동반된탈구시발생률이높다고보고하였으며발생빈도는 0% 에서 72% 까지보고가되고있고 13,20), Epstein 등 15) 은조기에관혈적정복술을시행하여관절내골절편을제거하고비구골절편을내고정하여안정성을유지하면외상성관절염의발생률을줄일수있다고하였다. 본연구에서추시 1 년후에 1 예 (5.6%) 발생하여인공고관절치환술을시 행하였다. 본연구의제한점은후향적연구로드물게발생하는대퇴골두골절이지만증례의수가적고 Pipkin III 형에대해서는연구가이루어지지않았으며, 수술방법의차이에따른예후등임상결과에영향을미치는다양한인자에대해파악하는데에도제한이있었다. Table 4. The Characteristics of 18 Patients Case Age Sex Pipkin Follow-up Clinical Type Treatment (Months) Result Complications F I *CR 6 Hours after Injury; 26 Good M I CR 5 Hours after Injury; 12 Excellent Excision of Fragment F I CR 12 Hours after Injury; 26 Excellent Excision of Fragment M I CR 3 Hours after Injury; 12 Excellent F II CR 5 Hours after Injury; 56 Good F II CR 3 Hours after Injury; 24 Good M IV CR Failed; 122 Poor AVN THA 2 Years after Injury M IV CR Failed; 72 Poor OA THA 1 Year after Injury F IV CR 12 Hours after Injury; 18 Fair AVN THA 5 Months after Injury M IV CR Failed; 65 Poor AVN THA 1 Year after Injury M IV CR Failed; 19 Fair M IV CR 6 Hours after Injury; 12 Good (Acetabulum) M IV CR 12 Hours after Injury; 12 Good M IV CR 8 Hours after Injury; 26 Good F IV CR 4 Hours after Injury; 24 Excellent M IV CR 2 Hours after Injury; 12 Good F IV CR 6 Hours after Injury; 12 Fair M IV CR 6 Hours after Injury; 12 Excellent * CR: Closed Reduction, ORIF: Open Reduction Internal Fixation, THA: Total Hip Arthroplasty, AVN: Avascular Necrosis of Femoral Head, OA: Post-traumatic Osteoarthritis. 63

8 결 론 처음내원시도수정복이가능한경우가임상결과가양호하였고도수정복이실패할수록대퇴골두무혈성괴사등의합병증발생빈도가높은경향을보였으며, 보다나은임상결과를얻기위해서는수상후가능한한빠른시간안에정복을시행해야할것으로사료된다. REFERENCES 01. Brumback RJ, Kenzora JE, Levitt LE, Burgess AR, Poka A. Fractures of the femoral head. Hip. 1987: Butler JE. Pipkin Type-II fractures of the femoral head. J Bone Joint Surg Am. 1981;63: Epstein HC. Traumatic dislocations of the hip. Clin Orthop Relat Res. 1973;(92): Thompson VP, Epstein HC. Traumatic dislocation of the hip; a survey of two hundred and four cases covering a period of twenty-one years. J Bone Joint Surg Am. 1951; 33-A:746-78; passim. 05.Pipkin G. Treatment of grade IV fracture-dislocation of the hip. J Bone Joint Surg Am. 1957;39-A: ; passim. 06.Canale ST, Campbell WC. Campbell s operative orthopaedics. 9th ed. St. Louis: Mosby; Rockwood CA, Green DP, Heckman JD, Bucholz RW. Rockwood and Green s fractures in adults. 5th ed. Philadelphia: Lippincott Williams & Wilkins; Stimson LA. Five cases of dislocation of the hip. NY Med J. 1889;50: Epstein HC. Posterior fracture-dislocations of the hip; long-term follow-up. J Bone Joint Surg Am. 1974;56: Lyddon DW Jr, Hartman JT. Traumatic dislocation of the hip with ipsilateral femoral fractures. A case report. J Bone Joint Surg Am. 1971;53: Gittins ME, Serif LW. Bilateral traumatic anterior/ posterior dislocations of the hip joints: case report. J Trauma. 1991;31: Stannard JP, Harris HW, Volgas DA, Alonso JE. Functional outcome of patients with femoral head fractures associated with hip dislocations. Clin Orthop Relat Res. 2000;(377): Marchetti ME, Steinberg GG, Coumas JM. Intermediateterm experience of Pipkin fracture-dislocations of the hip. J Orthop Trauma. 1996;10: Watson-Jones R, Wilson JN. Watson-Jones Fractures and joint injuries. 6th ed. New York: Churchill Livingstone; Epstein HC, Wiss DA, Cozen L. Posterior fracture dislocation of the hip with fractures of the femoral head. Clin Orthop Relat Res. 1985;(201): Pape HC, Rice J, Wolfram K, Gansslen A, Pohlemann T, Krettek C. Hip dislocation in patients with multiple injuries. A follow up investigation. Clin Orthop Relat Res. 2000;(377): Kim JH, Lee SH, Moon YL, Kim DH, Song KS. Treatment of femoral head fracture with traumatic posterior dislocation of the hip. J Korean Hip Soc. 2007;19: Park MS, Rho CK. Clinical analysis of femoral head fracture. J Korean Orthop Assoc. 1992;27: Kloen P, Siebenrock KA, Raaymakers ELFB, Marti RK, Ganz R. Femoral head fractures revisited. Eur J Trauma. 2002; 28: Hougaard K, Thomsen PB. Traumatic posterior fracturedislocation of the hip with fracture of the femoral head or neck, or both. J Bone Joint Surg Am. 1988;70:

9 Yerl-Bo Sung et al.: Traumatic Dislocation of the Hip with a Femoral Head Fracture 국문초록 대퇴골두골절을동반한외상성고관절탈구 성열보 최정윤 김종우인제대학교의과대학상계백병원정형외과학교실 목적 : 수술적으로치료받은대퇴골두골절을동반한외상성고관절탈구환자들의임상결과와합병증발생빈도를알아보고자하였다. 대상및방법 : 2002 년 11 월부터 2011 년 11 월까지내원한고관절탈구환자중대퇴골두골절이동반된 Thompson-Epstein V 형 18 예를대상으로하였다. 도수정복가능여부및정복시간에따라두군으로나누어 Epstein 기준에따라임상결과를평가하였고, 대퇴골두의무혈성괴사및외상성관절염발생빈도를분석하였다. 결과 : 전체환자중대퇴골두의무혈성괴사가 3 예, 외상성관절염이 1 예발생하였다. 도수정복이가능한군은 14 예, 실패한군은 4 예로두군간에임상결과는유의한차이를보였고, 전체합병증발생빈도에서유의한차이를보였다. 정복까지걸린시간은 6 시간이내가 10 예, 6 시간이후가 8 예로임상결과에서유의한차이를보이지않았으나, 경향성분석결과 6 시간이내에정복을시행할수록보다나은임상결과를보였으며, 전체합병증발생빈도에서유의한차이를보였다. 결론 : 대퇴골두골절을동반한외상성고관절탈구는도수정복이가능한경우가임상결과가양호하였으며, 보다나은임상결과를얻기위해서는수상후가능한한빠른시간안에정복을시행하여야할것으로사료된다. 색인단어 : 대퇴골두골절, 고관절탈구, Thompson-Epstein V 형 65

08-06김정호

08-06김정호 대한고관절학회지제 19 권제 3 호 Vol. 19, No. 3, September, 2007 외상성고관절후방탈구에동반된대퇴골두골절의치료 김정호 이상홍 문영래 김동휘 송근상 조선대학교의과대학정형외과학교실 목적 : 대퇴골두골절이동반된후방탈구환자의 Pipkin 분류에따른치료결과및합병증등을알아보고자하였다. 대상및방법 : 대퇴골두골절을동반한후방탈구중 Thompson-Epstein

More information

Lumbar spine

Lumbar spine Lumbar spine CT 32 111 DOI : 10.3831/KPI.2010.13.2.111 Lumbar Spine CT 32 Received : 10. 05. 23 Revised : 10. 06. 04 Accepted : 10. 06. 11 Key Words: Disc herniation, CT scan, Clinical analysis The Clinical

More information

11-12 김동수(국)

11-12 김동수(국) CASE REPORT Hip Pelvis 24(3): 250-255, 2012 http://dx.doi.org/10.5371/hp.2012.24.3.250 Traumatic Recurrent Dislocation of the Hip with Bankart Type Lesion - A Case Report - Dong-Soo Kim, MD, Hyun-Chul

More information

untitled

untitled SSN 12251682 (rint) SSN 22879293 (nline) 대한골절학회지제 27 권, 제 3 호, 2014 년 7 월 J Korean Fract Soc 2014;27(3):198205 http://dx.doi.org/10.12671/jkfs.2014.27.3.198 riginal Article 대퇴골두골절의수술적치료결과 강준순 문경호 이동주 양종혁

More information

- iii - - i - - ii - - iii - 국문요약 종합병원남자간호사가지각하는조직공정성 사회정체성과 조직시민행동과의관계 - iv - - v - - 1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 - - 8 - - 9 - - 10 - - 11 - - 12 - - 13 - - 14 - α α α α - 15 - α α α α α α

More information

012임수진

012임수진 Received : 2012. 11. 27 Reviewed : 2012. 12. 10 Accepted : 2012. 12. 12 A Clinical Study on Effect of Electro-acupuncture Treatment for Low Back Pain and Radicular Pain in Patients Diagnosed with Lumbar

More information

( ) Jkra076.hwp

( ) Jkra076.hwp Vol. 11, No. 4, December, 2004 Objective: Ultrasonography (USG) of joints has a unique position for the diagnosis of joint diseases. Bone surface, cartilage, periarticular soft tissue and their pathologic

More information

- i - - ii - - iii - - iv - - v - - vi - - 1 - - 2 - - 3 - 1) 통계청고시제 2010-150 호 (2010.7.6 개정, 2011.1.1 시행 ) - 4 - 요양급여의적용기준및방법에관한세부사항에따른골밀도검사기준 (2007 년 11 월 1 일시행 ) - 5 - - 6 - - 7 - - 8 - - 9 - - 10 -

More information

노영남

노영남 Purpose: Delayed massive hemorrhages from pseudoaneurysm rupture of the peripancreatic large arteries, after pancreaticoduodenectomy, are fatal. We reviewed the clinical course and outcome of bleeding

More information

<283732372D3733312920B4D9C3CAC1A120BCD2C7C1C6AEC4DCC5C3C6AEB7BBC1EEC0C720B3EBBEC8C0C720BDC3B7C2BAB8C1A4BFA120B4EBC7D120C0AFBFEBBCBA20C6F2B0A1283035292E687770>

<283732372D3733312920B4D9C3CAC1A120BCD2C7C1C6AEC4DCC5C3C6AEB7BBC1EEC0C720B3EBBEC8C0C720BDC3B7C2BAB8C1A4BFA120B4EBC7D120C0AFBFEBBCBA20C6F2B0A1283035292E687770> 대한안과학회지 제 49 권 제 5 호 2008 J Korean Ophthalmol Soc 49(5):727-731, 2008 DOI : 10.3341/jkos.2008.49.5.727 다초점 소프트콘택트렌즈의 노안의 시력보정에 대한 유용성 평가 김현경 1 김효명 2 정성근 1 가톨릭대학교 의과대학 성모병원 안과학교실 1, 고려대학교 의과대학 안암병원 안과학교실

More information

종골 부정 유합에 동반된 거주상 관절 아탈구의 치료 (1예 보고) 정복이 안된 상태로 치료 시에는 추후 지속적인 족부 동통의 원인이 되며, 이런 동통으로 인해 종골에 대해 구제술이나 2차적 재건술이 필요할 수도 있다. 2) 경종골 거주상 관절 탈구는 외국 문헌에 증례

종골 부정 유합에 동반된 거주상 관절 아탈구의 치료 (1예 보고) 정복이 안된 상태로 치료 시에는 추후 지속적인 족부 동통의 원인이 되며, 이런 동통으로 인해 종골에 대해 구제술이나 2차적 재건술이 필요할 수도 있다. 2) 경종골 거주상 관절 탈구는 외국 문헌에 증례 CSE REPORT 대한족부족관절학회지 제16권 제4호 2012 J Korean Foot nkle Soc. Vol. 16. No. 4. pp.270-275, 2012 종골 부정 유합에 동반된 거주상 관절 아탈구의 치료 (1예 보고) 인제대학교 의과대학 일산백병원 정형외과 차성무 장보훈 서진수 Treatment of Talonavicular Subluxation

More information

황지웅

황지웅 Comparison of Laparoscopy and Exploration in the Distal Pancreatectomy BACKGROUND: To determine the benefits of laparoscopic surgery compared with exploration, the clinical outcomes of open and laparoscopic

More information

- i - - ii - - iii - - iv - - v - - 1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 - - 8 - - 9 - - 10 - - 11 - - 12 - - 13 - - 14 - - 15 - - 16 - - 17 - - 18 - - 19 - α α - 20 - α α α α α α - 21 - - 22 - - 23 -

More information

( )Jkfs095.hwp

( )Jkfs095.hwp 대한골절학회지제 19 권, 제 4 호, 2006 년 10 월 Journal of the Korean Fractrure Society Vol. 19, N o. 4, October, 2006 팔씨름에의해발생한상완골간부및내상과골절 윤여헌 하종경 * 최경업 * 이관희 신상진 이화여자대학교의과대학목동병원정형외과, 서울적십자병원정형외과 * 목적 : 팔씨름중발생한상완골골절의발생기전및치료의결과를분석하였다.

More information

김범수

김범수 Analysis of Outcomes after Resection of Sarcomatous Hepatocellular Carcinoma Purpose: Sarcomatous hepatocellular carcinoma (HCC) is rare. Therefore, the clinicopathologic characteristics and prognosis

More information

07-09 김의창(국)

07-09 김의창(국) ORIGINAL ARTICLE Hip Pelvis 25(2): 121-126, 2013 http://dx.doi.org/10.5371/hp.2013.25.2.121 Print ISSN 2287-3260 Online ISSN 2287-3279 Recovery of Limitation of Motion in Secondary Osteoarthritis of the

More information

A 617

A 617 Special Issue Diabetic Retinopathy Won Ki Lee, M.D. Department of Ophthalmology The Catholic University of Korea College of Medicine Kangnam St. Mary s Hospital E mail : wklee@catholic.ac.kr Abstract R

More information

한국성인에서초기황반변성질환과 연관된위험요인연구

한국성인에서초기황반변성질환과 연관된위험요인연구 한국성인에서초기황반변성질환과 연관된위험요인연구 한국성인에서초기황반변성질환과 연관된위험요인연구 - - i - - i - - ii - - iii - - iv - χ - v - - vi - - 1 - - 2 - - 3 - - 4 - 그림 1. 연구대상자선정도표 - 5 - - 6 - - 7 - - 8 - 그림 2. 연구의틀 χ - 9 - - 10 - - 11 -

More information

1..

1.. Volume 12, Number 1, 6~16, Factors influencing consultation time and waiting time of ambulatory patients in a tertiary teaching hospital Jee-In Hwang College of Nursing Science, Kyung Hee University :

More information

( )Jkstro011.hwp

( )Jkstro011.hwp 비인강암의방사선치료결과및생존율에관한예후인자분석 2005 2 1 2005 3 28. :, Tel: 053)250-7665, Fax: 053)250-7984 E-mail: jhkim@dsmc.or.kr 정영연외 2 인 : 비인강암의예후인자분석 정영연외 2 인 : 비인강암의예후인자분석 Carcinoma of the nasopharynx treated by radiotherapy

More information

12이문규

12이문규 Review on Conservative Treatment of Spinal Scoliosis Moon-kyu Lee, O.M.D., Gil-jae Lee, O.M.D., Yun-kyung Song, O.M.D., Hyung-ho Lim, O.M.D. Dept. of Oriental Rehabilitation Medicine College of Oriental

More information

( )Kjhps043.hwp

( )Kjhps043.hwp Difference of Fistula Maturation Degree and Physical Property by the Types of Tube Material: An Experimental Study Sang Koo Kang, M.D. 1, Hee Chul Yu, M.D. 1,4, Woo Sung Moon, M.D. 2,4, Ju Hyoung Lee,

More information

<30312DC1A4BAB8C5EBBDC5C7E0C1A4B9D7C1A4C3A52DC1A4BFB5C3B62E687770>

<30312DC1A4BAB8C5EBBDC5C7E0C1A4B9D7C1A4C3A52DC1A4BFB5C3B62E687770> Journal of the Korea Institute of Information and Communication Engineering 한국정보통신학회논문지(J. Korea Inst. Inf. Commun. Eng.) Vol. 19, No. 2 : 258~264 Feb. 2015 ID3 알고리즘 기반의 귀납적 추론을 활용한 모바일 OS의 성공과 실패에 대한

More information

서론 34 2

서론 34 2 34 2 Journal of the Korean Society of Health Information and Health Statistics Volume 34, Number 2, 2009, pp. 165 176 165 진은희 A Study on Health related Action Rates of Dietary Guidelines and Pattern of

More information

386-390.hwp

386-390.hwp 386 HANYANG MEDICAL REVIEWS Vol. 29 No. 4, 2009 우리나라 미숙아의 통계와 의료비용 Statistics and Medical Cost of Preterm in Korea 윤혜선 을지대학교 노원을지병원 소아청소년과학교실 Hye Sun Yoon, M.D., Ph.D., Department of Pediatrics, Nowon

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA The e-business Studies Volume 17, Number 4, August, 30, 2016:319~332 Received: 2016/07/28, Accepted: 2016/08/28 Revised: 2016/08/27, Published: 2016/08/30 [ABSTRACT] This paper examined what determina

More information

원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 연세대학교대학원 의학과 남상현

원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 연세대학교대학원 의학과 남상현 원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 연세대학교대학원 의학과 남상현 원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 연세대학교대학원 의학과 남상현 원위부요척골관절질환에서의초음파 유도하스테로이드주사치료의효과 - 후향적 1 년경과관찰연구 - 지도김석원교수 이논문을석사학위논문으로제출함

More information

Kbcs002.hwp

Kbcs002.hwp Does Real-time Compound Imaging Improve Evaluation of reast Cancer Compared to Conventional Sonography? o Kyoung Seo, M.D., Yu Whan Oh, M.D., Kyu Ran Cho, M.D., Young Hen Lee, M.D., Hyung Joon Noh, M.D.,

More information

<342EBEC8BCBABFAD2CB9DAC7E2C1D82E687770>

<342EBEC8BCBABFAD2CB9DAC7E2C1D82E687770> 大 韓 癩 學 會 誌 : 第 41 卷, 第 1 號 2008 Korean Leprosy Bulletin, Vol. 41, No. 1, June, 2008 마비성 하안검 외반증에 대한 lateral tarsal strip의 재조명 안성열 성형외과의원 1), 제일병원 피부과 2) 안성열 1), 박향준 2) - Abstract - Reappraisal of the

More information

Abstract Background : Most hospitalized children will experience physical pain as well as psychological distress. Painful procedure can increase anxie

Abstract Background : Most hospitalized children will experience physical pain as well as psychological distress. Painful procedure can increase anxie Volume 12, Number 1, 92~102, An Intervention Study of Pain Reduction during IV Therapy in Hospitalized Children Myo-Jin Kim 1), Joung-Hae Bak 1), Won-Seok Seo 2) Mi-Young Kim 3), Sun-Kyoung Park 3), Jai-Soung

More information

590호(01-11)

590호(01-11) T H E K O R E A N D O C T O R S W E E K L Y www.docdocdoc.co.kr I N S I D E 38 3 5 6 7 10 13 28 29 30 31 38 41 42 2 Advertisement Government & Medicine 3 Government & Medicine 4 Government & Medicine Government

More information

(

( 317 318 319 320 1 3 5 5 5 5 2 321 : 1.,,,,, 06 2. X-ray beam penetration (density) (contrast) 03 3. patch coating, precipitation, flaking 03 4. centering 03 5. Esophagus, cardia, fundus, body, angle, antrum,

More information

05-08김원유

05-08김원유 J Korean Hip Soc 22(2): 116-121, 2010 Review Article Treatment for the Acetabular Fracture Weon-Yoo Kim, MD Department of Orthopedic Surgery, Daejeon St. Mary s Hospital, The Catholic University of Korea,

More information

04조남훈

04조남훈 Received : 2011. 11. 16 Reviewed : 2011. 11. 25 Accpeted : 2011. 12. 5 A Case Report of Prescribing Yanghyeolgeopung-tang(yangxuequfeng-tang) to Two Patients with Cervical Disc Herniation and Headache

More information

44-4대지.07이영희532~

44-4대지.07이영희532~ A Spatial Location Analysis of the First Shops of Foodservice Franchise in Seoul Metropolitan City Younghee Lee* 1 1 (R) 0 16 1 15 64 1 Abstract The foodservice franchise is preferred by the founders who

More information

139~144 ¿À°ø¾àħ

139~144 ¿À°ø¾àħ 2 139 DOI : 10.3831/KPI.2010.13.2.139 2 Received : 10. 04. 08 Revised : 10. 04. 26 Two Case Report on Wrist Ganglion Treated with Scolopendrid Pharmacopuncture Accepted : 10. 05. 04 Key Words: Wrist Ganglion,

More information

슬라이드 1

슬라이드 1 김태원, 최영 *, 원성훈, 박문석 *, 정진엽 * 울산병원, 분당서울대병원 *, 국군함평병원 Background Buddy taping is a well known useful method for treating dislocations, and other injuries of finger or toe. Background Buddy taping is a well

More information

<35BFCFBCBA2E687770>

<35BFCFBCBA2E687770> 주요개념 : 컴퓨터음란물 접촉자, 성지식, 성태도 남자중학생의 컴퓨터음란물 접촉자와 비접촉자간의 성지식과 태도의 차이 김 영 혜* 이 화 자** 정 향 미*** 1. 연구의 필요성 한국은 I. 서 론 1960 년대 이후부터 시작된 돌진적 산업화 ( 한 상진, 1996) 로 인하여 경제적 부흥을 이루어 집집마다 TV 수상기를 가질 수 있게 되었고 최근에는 PC보급율

More information

13-11윤형구

13-11윤형구 대한고관절학회지제 18 권제 1 호 Vol. 18, No. 1, March, 2006 대퇴골두무혈성괴사환자에서의대퇴골골두및경부골절 -4 례보고 - 포천중문의과대학분당차병원정형외과학교실 대퇴골두무혈성괴사환자에서속발되는대퇴골두및경부의골절발생은매우드물며이에대한골절의양상에대한분석과연관된보고는별로이루어져있지않은상태이다. 이에대한국내문헌상보고도거의없는실정이어서, 저자들은무혈성괴사로진단받아추시관찰중인환자들중에서초생달형태의골절과는전혀다른,

More information

Àå¾Ö¿Í°í¿ë ³»Áö

Àå¾Ö¿Í°í¿ë ³»Áö Disability & Employment 55 Disability & Employment 56 57 Disability & Employment 58 59 Disability & Employment 60 61 Disability & Employment 62 63 Disability & Employment 64 65 Disability & Employment

More information

자기공명영상장치(MRI) 자장세기에 따른 MRI 품질관리 영상검사의 개별항목점수 실태조사 A B Fig. 1. High-contrast spatial resolution in phantom test. A. Slice 1 with three sets of hole arr

자기공명영상장치(MRI) 자장세기에 따른 MRI 품질관리 영상검사의 개별항목점수 실태조사 A B Fig. 1. High-contrast spatial resolution in phantom test. A. Slice 1 with three sets of hole arr Original Article pissn 1738-2637 J Korean Soc Radiol 2012;67(2):129-134 The Survey of Magnetic Resonance Imaging Quality according to in Korea 1 자기공명영상장치(MRI) 자장세기에 따른 MRI 품질관리 영상검사의 개별항목점수 실태조사 1 Hyun-Hae

More information

Journal of Educational Innovation Research 2018, Vol. 28, No. 4, pp DOI: * A Research Trend

Journal of Educational Innovation Research 2018, Vol. 28, No. 4, pp DOI:   * A Research Trend Journal of Educational Innovation Research 2018, Vol. 28, No. 4, pp.295-318 DOI: http://dx.doi.org/10.21024/pnuedi.28.4.201812.295 * A Research Trend on the Studies related to Parents of Adults with Disabilities

More information

충북의대학술지 Chungbuk Med. J. Vol. 27. No. 1. 1~ Charcot-Marie-Tooth Disease 환자의마취 : 증례보고 신일동 1, 이진희 1, 박상희 1,2 * 책임저자 : 박상희, 충북청주시서원구충대로 1 번지, 충북대학교

충북의대학술지 Chungbuk Med. J. Vol. 27. No. 1. 1~ Charcot-Marie-Tooth Disease 환자의마취 : 증례보고 신일동 1, 이진희 1, 박상희 1,2 * 책임저자 : 박상희, 충북청주시서원구충대로 1 번지, 충북대학교 충북의대학술지 Chungbuk Med. J. Vol. 27. No. 1. 1~5 2017 Charcot-Marie-Tooth Disease 환자의마취 : 증례보고 신일동 1, 이진희 1, 박상희 1,2 * 책임저자 : 박상희, 충북청주시서원구충대로 1 번지, 충북대학교의과대학마취통증의학교실, 의학연구소 (28644), happycat19@hanmail.net

More information

Study on the Improvement of Management System through Analysis of golf semi- market: Focus on Physical Education Facility Act Ji-Myung Jung 1, Ju-Ho Park 2 *, & Youngdae Lee 3 1 Korea Institute of Sport

More information

Microsoft Word - 08-문준규.DOC

Microsoft Word - 08-문준규.DOC 대한골절학회지제 18 권, 제 1 호, 2005 년 1 월 Journal of the Korean Fracture Society Vol. 18, No. 1, January, 2005 근위부상완골골절의술후하방아탈구 문준규 남혁우 김종오 * 하종경 * 유석배 * 고려대학교의과대학정형외과학교실, 이화여자대학교의과대학정형외과학교실 * 목적 : 상완골근위부골절후발생하는하방아탈구에대해골절의양상,

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA The e-business Studies Volume 17, Number 6, December, 30, 2016:275~289 Received: 2016/12/02, Accepted: 2016/12/22 Revised: 2016/12/20, Published: 2016/12/30 [ABSTRACT] SNS is used in various fields. Although

More information

untitled

untitled ISSN 1225-1682 (Print) ISSN 2287-9293 (Online) 대한골절학회지제 29 권, 제 3 호, 2016 년 7 월 J Korean Fract Soc 2016;29(3):200-205 http://dx.doi.org/10.12671/jkfs.2016.29.3.200 Case Report 성인환자에서발생한동측의대퇴골간부골절에동반된전십자인대대퇴골부착부견열골절

More information

( )Jksc057.hwp

( )Jksc057.hwp 직장암환자의전직장간막절제술의 예측인자분석 : 불완전절제와절제시간에영향을미치는인자에관한연구 Analysis of Factors Affecting the Degree of Difficulty in Total Mesorectal Excision for Rectal Cancer: Investigation of the Factors Affecting Incomplete

More information

Journal of Educational Innovation Research 2017, Vol. 27, No. 2, pp DOI: : Researc

Journal of Educational Innovation Research 2017, Vol. 27, No. 2, pp DOI:   : Researc Journal of Educational Innovation Research 2017, Vol. 27, No. 2, pp.251-273 DOI: http://dx.doi.org/10.21024/pnuedi.27.2.201706.251 : 1997 2005 Research Trend Analysis on the Korean Alternative Education

More information

<30392EB9DAB0A1B6F72CC1A4B3B2BFEE2E687770>

<30392EB9DAB0A1B6F72CC1A4B3B2BFEE2E687770> 한국심리학회지 : 상담 및 심리치료 The Korean Journal of Counseling and Psychotherapy 2008, Vol. 20 No. 1, 161-182 성폭력 상담에서 내담자들이 지각한 도움경험(Helpful Experience): 질적 분석 * 박 가 람 정 남 운 가톨릭대학교 본 연구는 성폭력 상담에서 내담자들이 지각하는 도움경험과

More information

005송영일

005송영일 Received : 2015. 12. 09 Reviewed : 2015. 12. 16 Accepted : 2015. 12. 16 Sternal Fracture occurred after Thai Massage : A Case Report Young-Il Song, K.M.D. 1, Dong-Eun Kim, K.M.D. 1 1 Department of Rehabilitation

More information

하에서체중부하를하지않도록한다. 하지만전위가없는거골경부골절에서도비관혈적정복 후컴퓨터촬영상 1mm 이하의전위로해부학적정복이된경우에한해서빠른재활과관절의 운동을위해경피적나사못고정술을고려해볼수있다. (2) 제 2 형골절 : 제 2형골절은전위된골절로대부분거골하관절의아탈구또는탈구를

하에서체중부하를하지않도록한다. 하지만전위가없는거골경부골절에서도비관혈적정복 후컴퓨터촬영상 1mm 이하의전위로해부학적정복이된경우에한해서빠른재활과관절의 운동을위해경피적나사못고정술을고려해볼수있다. (2) 제 2 형골절 : 제 2형골절은전위된골절로대부분거골하관절의아탈구또는탈구를 Talus fractures and complications 조선대학교의과대학정형외과학교실 이준영 거골골절은전체족부골절의약 3% 정도로, 흔한골절은아니지만대부분이관절내골절이며발생시심각한합병증이동반되므로중요하게취급되어왔다. 거골은경골, 비골, 종골및주상골과관절을이루고있어족관절및중족부관절의관절운동에관여하게된다. 거골은근육이나건과의연결이없고주위구조물과는단지관절연골및활액막으로연결되어있다.

More information

09-02강호정

09-02강호정 대한견 주관절학회지제 10 권제 2 호 J. of Korean Shoulder and Elbow Society Volume 10, Number 2, December, 2007 견갑골관절와골절의수술적치료 연세대학교의과대학정형외과학교실, 광명성애병원정형외과 * 강호정 정성훈 정민 한수봉 김성재 김종민 * The Operative Treatment of Scapular

More information

( )Kju269.hwp

( )Kju269.hwp 만성세균성전립선염모델흰쥐에서 의항염효과 Anti-inflammatory Effect of Lycopene on Chronic Bacterial Prostatitis Rat Model Cho Hwan Yang, Dong Wan Sohn, Yong-Hyun Cho From the Department of Urology, The Catholic University

More information

Journal of Educational Innovation Research 2019, Vol. 29, No. 2, pp DOI: 3 * Effects of 9th

Journal of Educational Innovation Research 2019, Vol. 29, No. 2, pp DOI:   3 * Effects of 9th Journal of Educational Innovation Research 2019, Vol. 29, No. 2, pp.357-378 DOI: http://dx.doi.org/10.21024/pnuedi.29.2.201906.357 3 * Effects of 9th Grade Students Participation in Career Curriculum Cluster

More information

http://www.kbc.go.kr/pds/2.html Abstract Exploring the Relationship Between the Traditional Media Use and the Internet Use Mee-Eun Kang This study examines the relationship between

More information

433대지05박창용

433대지05박창용 Recent Changes in Summer Precipitation Characteristics over South Korea Changyong Park* JaYeon Moon** Eun-Jeong Cha*** Won-Tae Yun**** Youngeun Choi***** 1958 2007 6 9 6 9 10 10 10 10 10 Abstract This

More information

16(1)-3(국문)(p.40-45).fm

16(1)-3(국문)(p.40-45).fm w wz 16«1y Kor. J. Clin. Pharm., Vol. 16, No. 1. 2006 x w$btf3fqpsu'psn û w m w Department of Statistics, Chonnam National University Eunsik Park College of Natural Sciences, Chonnam National University

More information

본문01

본문01 Ⅱ 논술 지도의 방법과 실제 2. 읽기에서 논술까지 의 개발 배경 읽기에서 논술까지 자료집 개발의 본래 목적은 초 중 고교 학교 평가에서 서술형 평가 비중이 2005 학년도 30%, 2006학년도 40%, 2007학년도 50%로 확대 되고, 2008학년도부터 대학 입시에서 논술 비중이 커지면서 논술 교육은 학교가 책임진다. 는 풍토 조성으로 공교육의 신뢰성과

More information

16_이주용_155~163.hwp

16_이주용_155~163.hwp 사상체질의학회지 2008;20(2):155-163 J of Sasang Constitutional Medicine Vol. 20, No. 2, 2008:155-163 http://www.esasang.com 腦 梗 塞 으로 발생한 少 陽 人 半 身 舞 蹈 病 患 者 치험 1례 이주용 이한얼 한경수 안택원 Abstract 대전대학교 한의과대학 사상체질과 A Soyangin

More information

A Study on Married Female Immigrants Life Style and Marriage Satisfaction in Terms of Preparing Their Old Age in Chungcheongnam-do Department of Gerontology, Hoseo University Doctoral Student : Hi Ran

More information

Analyses the Contents of Points per a Game and the Difference among Weight Categories after the Revision of Greco-Roman Style Wrestling Rules Han-bong

Analyses the Contents of Points per a Game and the Difference among Weight Categories after the Revision of Greco-Roman Style Wrestling Rules Han-bong Analyses the Contents of Points per a Game and the Difference among Weight Categories after the Revision of Greco-Roman Style Wrestling Rules Han-bong An 1 & Kyoo-jeong Choi 2 * 1 Korea National Wrestling

More information

Can032.hwp

Can032.hwp Chromosomal Alterations in Hepatocellular Carcinoma Cell Lines Detected by Comparative Genomic Hybridization Sang Jin Park 1, Mahn Joon Ha, Ph.D. 1, Hugh Chul Kim, M.D. 2 and Hyon Ju Kim, M.D. 1 1 Laboratory

More information

untitled

untitled 대한족부족관절학회지 : 제 8 권제 호 4 J Korean Foot Ankle Soc. Vol 8. No.. pp.86-9, 4 한전의료재단한일병원정형외과 라종득 박현수 임창석 장영수 박상원 정태원 전용수 Comparison of the Results after the Surgical Treatments of the Trimalleolar Ankle Fractures

More information

달생산이 초산모 분만시간에 미치는 영향 Ⅰ. 서 론 Ⅱ. 연구대상 및 방법 達 은 23) 의 丹 溪 에 최초로 기 재된 처방으로, 에 복용하면 한 다하여 난산의 예방과 및, 등에 널리 활용되어 왔다. 達 은 이 毒 하고 는 甘 苦 하여 氣, 氣 寬,, 結 의 효능이 있

달생산이 초산모 분만시간에 미치는 영향 Ⅰ. 서 론 Ⅱ. 연구대상 및 방법 達 은 23) 의 丹 溪 에 최초로 기 재된 처방으로, 에 복용하면 한 다하여 난산의 예방과 및, 등에 널리 활용되어 왔다. 達 은 이 毒 하고 는 甘 苦 하여 氣, 氣 寬,, 結 의 효능이 있 대한한방부인과학회지 THE JOURNAL OF ORIENTAL OBSTETRICS & GYNECOLOGY VOL.17, NO.2 : 115-122 (2004) 달생산이 초산모 분만시간에 미치는 영향 * 북경한의원, ** 윤산부인과의원, *** 최은림산부인과의원, 상지대학교 한의과대학 부인과학교실 ****, 경희대학교 동서의학대학원 김성준 *****, 윤왕준

More information

03이경미(237~248)ok

03이경미(237~248)ok The recent (2001-2010) changes on temperature and precipitation related to normals (1971-2000) in Korea* Kyoungmi Lee** Hee-Jeong Baek*** ChunHo Cho**** Won-Tae Kwon*****. 61 (1971~2000) 10 (2001~2010).

More information

,,,.,,,, (, 2013).,.,, (,, 2011). (, 2007;, 2008), (, 2005;,, 2007).,, (,, 2010;, 2010), (2012),,,.. (, 2011:,, 2012). (2007) 26%., (,,, 2011;, 2006;

,,,.,,,, (, 2013).,.,, (,, 2011). (, 2007;, 2008), (, 2005;,, 2007).,, (,, 2010;, 2010), (2012),,,.. (, 2011:,, 2012). (2007) 26%., (,,, 2011;, 2006; ,,.. 400,,,,,,.,,, -, -, -., 3.. :, Tel : 010-9540-0640, E-mail : sunney05@hanmail.net ,,,.,,,, (, 2013).,.,, (,, 2011). (, 2007;, 2008), (, 2005;,, 2007).,, (,, 2010;, 2010), (2012),,,.. (, 2011:,, 2012).

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA The e-business Studies Volume 17, Number 6, December, 30, 2016:237~251 Received: 2016/11/20, Accepted: 2016/12/24 Revised: 2016/12/21, Published: 2016/12/30 [ABSTRACT] Recently, there is an increasing

More information

Trd022.hwp

Trd022.hwp 김신태, 이선녕, 이석정, 정필문, 박홍준, 신명상, 김종환, 이부길, 김상하, 리원연, 신계철, 용석중 Shin-Tae Kim, M.D., Shun Nyung Lee, M.D., Seok Jeong Lee, M.D., Pil Moon Jung, M.D., Hong Jun Park, M.D., Myung Sang Shin, M.D., Chong Whan Kim,

More information

10-14-조재호

10-14-조재호 대한수부외과학회지제 13 권제 3 호 The Journal of the Korean Society for Surgery of the Hand VOLUME 13, NUMBER 3, September 2008 아주대학교의과대학정형외과학교실 Surgical Treatment of Transolecranon Fracture-Subluxation of the Elbow

More information

66 pissn : , eissn : Case Report J Korean Orthop Assoc 2018; 53: 삼방연골손

66 pissn : , eissn : Case Report J Korean Orthop Assoc 2018; 53: 삼방연골손 66 pissn : 1226-2102, eissn : 2005-8918 Case Report J Korean Orthop Assoc 2018; 53: 66-70 https://doi.org/10.4055/jkoa.2018.53.1.66 www.jkoa.org 삼방연골손상후발생한골가교의보존적치료 차용한 을지대학교의과대학정형외과학교실 Yong Han Cha, M.D.,

More information

세라뉴스-2011내지도큐

세라뉴스-2011내지도큐 2 2 8 17 18 22 23 24 Heinrich Wecker 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 예정된 이벤트 증례2 : 세라믹-폴리에틸렌 고관절 치환술후 발생한 비구-대퇴 해리로 세라믹-세라믹 관절면을 사용하여 재수술 진단 : 고관절 통증으로 내원한 65세 여자환자, 20년전 세라믹-폴리에틸

More information

001-학회지소개(영)

001-학회지소개(영) Review Article Randomization, What is the Proper Method? Jin Ho Hong, M.D., Jae Chul Yoo, M.D. Shoulder & Sports medicine, Department of Orthopedic Surgery, Samsung Medical Center Purpose: Among the numerous

More information

11-09-김원유

11-09-김원유 대한고관절학회지제 18 권제 1 호 Vol. 18, No. 1, March, 2006 대퇴전자부골절환자의양극성인공골두치환술시전자골절편의내고정법 가톨릭대학교의과대학대전성모병원정형외과 목적 : 고령의대전자간골절편을포함한전자간골절이있는환자의인공골두치환술을시행하는데있어대전자부골절편에대한고정방법을후향적연구를통해이를비교하여보고하고자한다. 대상및방법 : 대전자부의부착이문제가될수있는

More information

10-10황성관

10-10황성관 Original Article Comparison of Conventional and Digital Templating Technique in Total Hip Arthroplasty Sung Kwan Hwang, MD, PhD, Dong Hyun Kang, MD, Tae Yeon Cho, MD, Chang Ho Lee, MD Department of Orthopedic

More information

<35335FBCDBC7D1C1A42DB8E2B8AEBDBAC5CDC0C720C0FCB1E2C0FB20C6AFBCBA20BAD0BCAE2E687770>

<35335FBCDBC7D1C1A42DB8E2B8AEBDBAC5CDC0C720C0FCB1E2C0FB20C6AFBCBA20BAD0BCAE2E687770> Journal of the Korea Academia-Industrial cooperation Society Vol. 15, No. 2 pp. 1051-1058, 2014 http://dx.doi.org/10.5762/kais.2014.15.2.1051 멤리스터의 전기적 특성 분석을 위한 PSPICE 회로 해석 김부강 1, 박호종 2, 박용수 3, 송한정 1*

More information

11¹ÚÇý·É

11¹ÚÇý·É Journal of Fashion Business Vol. 6, No. 5, pp.125~135(2002) The Present State of E-Business according to the Establishment Year and the Sales Approach of Dongdaemun Clothing Market Park, Hea-Ryung* and

More information

Journal of Educational Innovation Research 2019, Vol. 29, No. 1, pp DOI: : * Research Subject

Journal of Educational Innovation Research 2019, Vol. 29, No. 1, pp DOI:   : * Research Subject Journal of Educational Innovation Research 2019, Vol. 29, No. 1, pp.91-116 DOI: http://dx.doi.org/10.21024/pnuedi.29.1.201903.91 : * Research Subject Trend Analysis on Educational Innovation with Network

More information

54 한국교육문제연구제 27 권 2 호, I. 1.,,,,,,, (, 1998). 14.2% 16.2% (, ), OECD (, ) % (, )., 2, 3. 3

54 한국교육문제연구제 27 권 2 호, I. 1.,,,,,,, (, 1998). 14.2% 16.2% (, ), OECD (, ) % (, )., 2, 3. 3 27 2, 53-70, 2009. (Nursing Home) * ** (Nursing Home). 5 50 5 2 1,,,,, SPSS t.,,,,,,,. :,, : 2009/08/27 : 2009/09/24 : 2009/09/30 * ** (: hjkim@daelim.ac.kr) 54 한국교육문제연구제 27 권 2 호, 2009. I. 1.,,,,,,, (,

More information

....-42.(11+12.).pdf

....-42.(11+12.).pdf www.himchanhospital.com 2011:11+12 www.himchanhospital.com Himchan People CONTENTS 2011 11+12 HIMCHAN PEOPLE 02 04 07 08 10 12 13 14 16 HIMCHAN NETWORK 18 19 22 04+05 Himchan People 06+07 Himchan People

More information

10-06 오광준(국)

10-06 오광준(국) ORIGINAL ARTICLE http://dx.doi.org/10.5371/hp.2012.24.2.139 Surgical Fixation of Sacroiliac Joint Complex in Unstable Pelvic Ring Injuries Kwang-Jun Oh, MD, Seok-Min Hwang, MD Department of Orthopedic

More information

( )Jkoa112.hwp

( )Jkoa112.hwp J Korean Orthop Assoc 2006; 41: 680-686 80 세이상노인의대퇴경부골절에시행한무시멘트형양극성고관절반치환술 박시영 * 양익환 김성환 한창동 Cementless Bipolar Hemiarthroplasty for Femoral Neck Fracture in Patients More than Eighty Years Old Purpose:

More information

487 Cerclage Clamping for Reduction of Anterior and Posterior Column Fracture 경우가 많으며 또한 주변 신경 및 혈관 손상에 대한 위험성이 있 8) 고정술을 시행한 25예 중 본 연구에서 소개한 cerclag

487 Cerclage Clamping for Reduction of Anterior and Posterior Column Fracture 경우가 많으며 또한 주변 신경 및 혈관 손상에 대한 위험성이 있 8) 고정술을 시행한 25예 중 본 연구에서 소개한 cerclag 486 pissn : 1226-2102, eissn : 2005-8918 Original Article J Korean Orthop Assoc 2016; 51: 486-492 https://doi.org/10.4055/jkoa.2016.51.6.486 www.jkoa.org 비구전후주골절에대해서 Cerclage Passer 를이용한환상강선고정술기및결과 박기철

More information

ECG & EP CASES Young-Keun On, MD, PhD Division of Cardiology, Department of Medicine Cardiac & Vascular Center, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Korea A case of

More information

[ 영어영문학 ] 제 55 권 4 호 (2010) ( ) ( ) ( ) 1) Kyuchul Yoon, Ji-Yeon Oh & Sang-Cheol Ahn. Teaching English prosody through English poems with clon

[ 영어영문학 ] 제 55 권 4 호 (2010) ( ) ( ) ( ) 1) Kyuchul Yoon, Ji-Yeon Oh & Sang-Cheol Ahn. Teaching English prosody through English poems with clon [ 영어영문학 ] 제 55 권 4 호 (2010) 775-794 ( ) ( ) ( ) 1) Kyuchul Yoon, Ji-Yeon Oh & Sang-Cheol Ahn. Teaching English prosody through English poems with cloned native intonation. The purpose of this work is to

More information

Journal of Educational Innovation Research 2018, Vol. 28, No. 1, pp DOI: * A Study on the Pe

Journal of Educational Innovation Research 2018, Vol. 28, No. 1, pp DOI:   * A Study on the Pe Journal of Educational Innovation Research 2018, Vol. 28, No. 1, pp.405-425 DOI: http://dx.doi.org/10.21024/pnuedi.28.1.201803.405 * A Study on the Perceptions and Factors of Immigrant Background Youth

More information

( )jkfs076.hwp

( )jkfs076.hwp 대한골절학회지제 19 권, 제 3 호, 2006 년 7 월 Journal of the Korean Fractrure Society Vol. 19, N o. 3, July, 2006 후향적유연성금속정을이용한상완골간부골절의치료 정필현황정수강석김종필김영성박승복안광욱 동국대학교의과대학정형외과학교실 목적 : 상완골간부골절에있어후향적유연성금속정을이용한골수강내고정술의임상적및방사선학적결과에대해보고하고자한다.

More information

untitled

untitled 대한정형외과학회지 : 제 43 권제 6 호 2008 J Korean Orthop Assoc 2008; 43: 672-676 소아족관절성장판손상후성장판조기유합에영향을미치는인자 김정렬ㆍ송광훈 전북대학교의학전문대학원정형외과학교실, 임상의학연구소 Factors Influencing Premature Physeal Closure following Physeal Injury

More information

2 1896 2 26 ( ) 2 7-20 2) 1897 1898 ( )3) 6 1902 8 1904 10 10 (19 05-1914 ) ( ) ( ) 4) 1915 ( ) ( ) 1917 2) 3) 4) 285

2 1896 2 26 ( ) 2 7-20 2) 1897 1898 ( )3) 6 1902 8 1904 10 10 (19 05-1914 ) ( ) ( ) 4) 1915 ( ) ( ) 1917 2) 3) 4) 285 13 2 ( 25 ) 2004 12 Korean J Med Hist 13 284 296 Dec 2004 ISSN 1225 505X 1) * ** ** 1 1920 1930 40 ( 1896-1973) 80 * ** 1) 2003 284 2 1896 2 26 ( ) 2 7-20 2) 1897 1898 ( )3) 6 1902 8 1904 10 10 (19 05-1914

More information

<30382EC0C7C7D0B0ADC1C22E687770>

<30382EC0C7C7D0B0ADC1C22E687770> 대한내과학회지: 제 76 권 제 2 호 2009 의학강좌-개원의를 위한 모범처방(Current Clinical Practice) 간기능검사의 이해와 적용 인제대학교 의과대학 일산백병원 내과학교실 김 경 아 Understanding and application of liver function tests Kyung-Ah Kim, M.D. Department of

More information

제5회 가톨릭대학교 의과대학 마취통증의학교실 심포지엄 Program 1 ANESTHESIA (Room 2층 대강당) >> Session 4 Updates on PNB Techniques PNB Techniques for shoulder surgery: continuou

제5회 가톨릭대학교 의과대학 마취통증의학교실 심포지엄 Program 1 ANESTHESIA (Room 2층 대강당) >> Session 4 Updates on PNB Techniques PNB Techniques for shoulder surgery: continuou 제5회 가톨릭대학교 의과대학 마취통증의학교실 심포지엄 (Room 2층 대강당) >> Session 4 Updates on PNB Techniques PNB Techniques for shoulder surgery: continuous vs single injection, interscalene vs supraclavicular approach 의정부성모병원

More information

07-01 임채현(국)

07-01 임채현(국) ORIGINAL ARTICLE http://dx.doi.org/10.5371/hp.2013.25.1.44 Print ISSN 2287-3260 Online ISSN 2287-3279 Hemiarthroplasty for Hip Fractures in Elderly Patients over 80 Years Old - Comparative Analysis between

More information

untitled

untitled ISSN 1225-1682 (Print) ISSN 2287-9293 (Online) 대한골절학회지제 28 권, 제 1 호, 2015 년 1 월 J Korean Fract Soc 2015;28(1):30-37 http://dx.doi.org/10.12671/jkfs.2015.28.1.30 Original Article 수술후발생한주두골불유합의치료 강호정 김지섭

More information

CASE REPORT pissn eissn J Korean Soc Surg Hand 2016;21(4): JOURNAL OF THE KORE

CASE REPORT pissn eissn J Korean Soc Surg Hand 2016;21(4): JOURNAL OF THE KORE CASE REPORT pissn 1598-3889 eissn 2234-0998 J Korean Soc Surg Hand 2016;21(4):225-229. http://doi.org/10.12790/jkssh.2016.21.4.225 JOURNAL OF THE KOREAN SOCIETY FOR SURGERY OF THE HAND Volar Dislocation

More information

Jkbcs012( ).hwp

Jkbcs012( ).hwp Complications and Reasons for Dissatisfaction in Augmentation Mammoplasty - Analysis of 42 Cases of Re-operation - Sangdal Lee M.D. Clinic Purpose: Breast augmentation has recently become a common plastic

More information

K O R E A C E N T E R S F O R D I S E A S E C O N T R O L & P R E V E N T I O N PHWR Vol. 5 No. 41 www.cdc.go.kr/phwr 2012 10 12 5 41 ISSN:2005-811X Comparison of drug-susceptibility test to the anti-tuberculosis

More information

. 45 1,258 ( 601, 657; 1,111, 147). Cronbach α=.67.95, 95.1%, Kappa.95.,,,,,,.,...,.,,,,.,,,,,.. :,, ( )

. 45 1,258 ( 601, 657; 1,111, 147). Cronbach α=.67.95, 95.1%, Kappa.95.,,,,,,.,...,.,,,,.,,,,,.. :,, ( ) . 45 1,258 ( 601, 657; 1,111, 147). Cronbach α=.67.95, 95.1%, Kappa.95.,,,,,,.,...,.,,,,.,,,,,.. :,, (402-751) 253 E-mail : yspark@inha.ac.kr ,. (, 2011),, 1980 5 49.9%, 4 (20.3%). 1985, 5 (39.0%), 4 (25.3%).

More information

YI Ggodme : The Lives and Diseases of Females during the Latter Half of the Joseon Dynasty as Reconstructed with Cases in Yeoksi Manpil (Stray Notes w

YI Ggodme : The Lives and Diseases of Females during the Latter Half of the Joseon Dynasty as Reconstructed with Cases in Yeoksi Manpil (Stray Notes w 497 의사학 제24권 제2호(통권 제50호) 2015년 8월 Korean J Med Hist 24 ː497-532 Aug 2015 c대한의사학회 http://dx.doi.org/10.13081/kjmh.2015.24.497 pissn 1225-505X, eissn 2093-5609 역시만필( 歷 試 漫 筆 ) 의 사례로 재구성한 조선후기 여성의 삶과 질병

More information

DBPIA-NURIMEDIA

DBPIA-NURIMEDIA e- 비즈니스연구 (The e-business Studies) Volume 17, Number 1, February, 28, 2016:pp. 3~30 ISSN 1229-9936 (Print), ISSN 2466-1716 (Online) 원고접수일심사 ( 수정 ) 게재확정일 2016. 01. 08 2016. 01. 09 2016. 02. 25 ABSTRACT

More information