대한 근골격계 초음파 학회 ( KAOM ) 김 응 록 정형외과 김 응 록 M.D, Ph.D.

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Presentation transcript:

대한 근골격계 초음파 학회 ( KAOM ) 김 응 록 정형외과 김 응 록 M.D, Ph.D

 F/ 60  Rt. ankle pain  Tenderness( anterior )  Lateral malleolar fracture 로 타병원 수술

 타병원 수술전 preoperative simple ankle AP, lateral, mortise 사진이다.  Lateral malleolus 의 fracture line( arrow ) 이 보인다.

 Lateral malleolar fracture 로 타병원 수술 ( OR/IF with plate and screw ) 시행후 사진이다.  환자는 수술 부위보다 anterior 의 pain 을 호소 하였다.

F T F: fibular, T: Tibia

Ankle joint anterior 에서 syndesmosis 을 중심으로 실시한 short axis scan 이다. ( 화면 좌측 하단의 probe position 참조 ) Syndesmosis ligament 가 swelling 되어 보인다. ( arrow ) ( F: fibular, T: tibia )

Normal lesion

 건측에 비하여 swelling 되어 있어 ( arrow ) syndesmosis 의 손상을 시사하는 sonographic finding 이다.

Imp) Syndesmosis sprain ( ant. Inf. Tibiofibular ligament injury ) REC) Prolotheraphy

F T F: fibular, T: tibia

 Prolotheraphy 후 1 개월후 추시 scan 이다. Prolotheraphy 전에 swelling 되어 있던 부분이 소실 되었다.( arrow )  Prolotheraphy 후 pain 의 vas score 는 2 로 감소되었다. 문진상 작업 시에도 pain 은 없었다.

 Syndesmosis  Interosseous ligament  Ant. & post. (distal)Tibiofibular ligament  Transverse ligament

Anatomy of the distal tibiofibular syndesmosis in adults : a pictorial essay with a multimodality approach John J, Hermans et al : J. Anat. (2010) 217, pp633–645