• Title/Summary/Keyword: 골절 정복

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The Results of Ender Nailing for the Proximal Humerus Fractures - Radiological Evaluation - (상완골 근위부 골절의 Erlder 정을 이용한 치료 결과-방사선학적 분석 -)

  • Park Jin Soo;Chung Moon Sang;Yoon Kang Sub;Baek Goo Hyun;Lee Ji Ho;Kang Seung Baek;Kim Dong Wook
    • Clinics in Shoulder and Elbow
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    • v.2 no.2
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    • pp.187-198
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    • 1999
  • Purpose: The authors compared the results of Ender nailing for the proximal humerus fractures with those of the conservative methods radiographically. Materials and Method: Nine patients(mean age: 69 years.) received Ender nailing, and the other nine patients, conservative treatments(mean age: 73 years). All fractures were 2 part fractures. The Ender nails were inserted either through posterior elbow approach or transepicondylar approach. A simple Velpeau bandage was applied to the conservative treatment group. The average follow-up was 15 months. Results: The initial status of the anatomical reduction, i.e., the values of the medial shift, overlapping and the varus agulation, were little changed at follow-up radiographs in both the Ender nailing group and the conservative treatment group. There was no significant difference for the status of anatomical reduction between the Ender nailing group and the conservative treatment group. The stability of fixation by Ender nails, i.e., the degree of fanning out of the nails was poor in most cases. Not a few problems/complications happened in cases of Ender nailing group; back­ing out of the nail in three cases, penetration of the nails into the humeral heads in 3, fractures or cracking of the humerus around the nail insertion area in 4 and reduction loss in one. Conclusion: We could not get better results with the use of Ender nail. We use no longer Ender nails for the proximal humerus fractures. Further studies are needed for the better option for the proximal humerus fractures.

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Arthroscopic Reduction and Fixation of an Anterior Cruciate Ligament Avulsion Fracture From the Tibial Eminence Using Bioabsorbable Pins - Technical Note - (생흡수성 핀을 이용한 소아 경골 과간부 견열 골절의 관절경적 정복 및 고정 방법 - 수술 술기 -)

  • Lee, Su-Chan;Yang, Il-Soon;Seo, Hee-Soo
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.2
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    • pp.183-187
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    • 2009
  • Purpose: We describe a new and simple technique for arthroscopic fixation of tibial intercondylar eminence avulsion fracture using bioabsorbable pins in skeletally immature patients. Operative Technique: Diagnostic knee arthroscopy is performed using anterolateral and anteromedial portals. Fracture debris and blood clot are debrided to expose the injured site well. The fragment is reduced with the probe and fixed temporarily with a 1.1-mm diameter K-wire that is inserted percutaneously from the anterosuperior aspect of the knee joint. The drill guide is introduced into the joint and the fragment is secured by bioabsorbable, poly-p-dioxanone 1.3-mm pins inserted from different angles. The pins are 40 mm in length. The knee is placed in a long leg cast in extension for 4 weeks to assure that full extension is obtained. Conclusion: Arthroscopic fixation of an tibial intercondylar eminence avulsion fracture using bioabsorbable pins is not a technically demanding, suitable method that ensures fracture healing and restores the stability of the joint.

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A Clinical Study of Femur Neck Fractures (대퇴 경부 골절의 임상적 고찰)

  • Koo, Hwan-Mo;Ahn, Myun-Whan;Ihin, Joo-Choul
    • Journal of Yeungnam Medical Science
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    • v.7 no.1
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    • pp.69-80
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    • 1990
  • A clinical analysis was done on 23 patients(24 hips) with fracture of the femoral neck, who had been admitted and treated at our Orthopedic department during the period of 4 years, from Jan, 1984 to May 1988. The results were as follows : 1. 23 patients were comprised of 4 males and 19 females, and 11 patients were over 65 years old. 2. 18 cases of 24 cases were due to minor traumas such as slipping down, and for over 65 years old, all cases were due to simple minor traumas, 8 cases were showed a severe osteoporosis, below grade 3 of the Singh's index. 3. 14 cases of 24 cases were displaced subcapital fractures, and 6 cases displaced transcervical fractures. Only 4 cases were the undisplaced transcervical fractures. 4. In treatment of fractures internal fixations after manipulation were performed in 14 cases and primary arthroplasties in 10 cases. Secondary arthroplasties were done in complicated 4 cases of 14 cases treated with internal fixations. 5. Complications after internal fixation were developed in 7 cases out of 14 cases, avascular necrosis in 6, nonunions in 2, pin migrations in 3, and metal failure in 1 case. 6. In 14 arthroplasty immediate surgical fitness of femoral stem were related to late loosening of femoral stem(correlation coefficient r=-0.68, p<0.01).

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Operative Treatment of Capitellar Fractures Associated with/without Other Injury Around the Elbow (단순 혹은 주관절 주위 손상을 동반한 소두 골절의 수술적 치료)

  • Kang, Ho-Jung;Park, Kwang-Hwan;Lee, Jung-Kil;Choi, Yun-Rak;Hahn, Soo-Bong;Kim, Sung-Jae
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.142-149
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    • 2009
  • Purpose: We wanted to assess the radiological and clinical results and the prognostic factors after an operation for capitellar fractures associated with/without other injury around the elbow. Materials and Methods: Among the 25 patients (mean age: 49 years-old) who underwent open reduction and internal fixation for capitellar fractures, there were nineteen type 1 fractures and six type 3 fractures. The mean follow up period was 14.8 months. We assessed the factors affecting the radiological and functional results, such as the fracture pattern, the patient age and the surgical approaches. Results: In 24 of 25 patients, bony union was achieved at postoperative 1 year. There were eighteen excellent, four good, two fair and one poor functional results according to the Broberg and Morrey elbow score. The most common type was type 1 and the most common associated injury was lateral condylar fracture. The patients with type 1 fracture rather than the patients with type 3 fracture and the patients who had an extraarticular associated fracture rather than an intraarticular associated fracture had better clinical outcomes. Conclusion: 22 (88%) of the patients were satisfied at the result. The type of capitellar fracture and an associated intraarticular elbow fracture were shown to be important prognostic factors in this study.

Use of Cross Pins and Temporal External Skeletal Fixator for Stabilization of a Tibial Physeal Fracture in a Korean Native Calf (한우 송아지의 정강뼈 성장판 골절에서의 교차핀과 임시 외부 골격 고정장치의 이용)

  • Heo, Su-Young;Kim, Eun-Ju;Kim, Min-Su;Lee, Ki-Chang;Kim, Nam-Soo;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.29 no.2
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    • pp.198-201
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    • 2012
  • A one-month-old, male Hanwoo calf was presented to Chonbuk Animal Medical Center with non-weight bearing lameness on its right hindlimb. The radiograph and CT scan showed a Salter-Harris III fracture at the distal tibia. Following open reduction, the fracture was stabilized by cross-pins. A temporal external skeletal fixator was used as an additional support for 5 weeks. 5 weeks after surgery, bone fracture had successfully healed with no complication. At 2 years after surgery, the calf could walk almost normally although intermittent weight-bearing lameness after active exercise. This is a rare case that the combined use of temporal external fixation and cross-pins fixation was sufficiently effective for treating a distal tibial physeal fracture in a calf.

Treatment of Two- and Three-Part Fracture of Proximal Humerus using LCP (잠김 압박 금속판(LCP)을 이용한 상완골 근위부 이분 및 삼분 골절의 치료)

  • Shin, Sung-Il;Song, Kyung-Won;Lee, Jin-Young;Lee, Seung-Yong;Kim, Gab-Rae;Hyun, Yoon-Suk;Park, Deok-Yong
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.204-211
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    • 2007
  • Purpose: To evaluate the result and complication of treatment using Locking Compression Plate (LCP) for fracture of proximal humerus. Materials and Methods: Between 2004 and 2006, 21 patients with two-part and three-part fractures of the proximal humerus were treated by LCP fixation. Their average age was 54.9 years. Postoperative mean follow-up period was 22.9 months. The reduction was qualified and complication were assessed with final radiographs. The functional outcome was evaluated by Neer's rating system. Results: By Neer's functional evaluation, mean score of shoulder function was 86.3 and 18 case (86%) had excellent or satisfactory results. There was one case of nonunion but no infection or avascular necrosis of the humeral head. No correlation was found between the final result and the type of fracture, age, gender or quality of reduction. Conclusion: We obtained satisfactory result of LCP fixation for fracture of proximal humerus in this study. LCP fixation for proximal humerus fracture is a reliable method to obtain satisfactory reduction, rigid fixation and early exercise.

MIDFACIAL DEGLOVING APPROACH IN MIDFACIAL BONE FRACTURE : THE REPORT OF CASES (Midfacial degloving approach를 이용한 중안면 골절 환자의 치험례)

  • Kim, Hyeon-Min;Jeong, Jong-Cheol;Song, Min-Seok;Jang, Jung-Hui;Kim, Nam-Hun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.1
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    • pp.74-81
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    • 2005
  • In 1974, Casson et. al. reported midfacial degloving approach to repair the midfacial bone fracture. After then, this approach has been used frequently to treat the lesions on nasal cavity, nasopharynx, facial plastic surgery and midfacial trauma. Midfacial degloving approach consists of 1) bilateral sublabial incision 2) complete transfixion incision/ septocolumellar incision 3) bilateral intercartilaginous incision 4) bilateral pyriform aperature incision. This approach provides proper access for midfacial bone structure without facial scar but has post-operative complications such as transient epistaxis, infraorbital nerve paresthesia and nasal crust. We treated three patients using midfacial degloving approach to correct traumatic deformity in midface area. In two patients, rhinoplasty with autogenous rib graft was done simultaneously. So we report these cases with review of literatures.

Surgical Treatment Using Anchor Suture of Coracoid Process Fracture with Acromioclavicular Joint Dislocation - A Case Report - (견봉-쇄골관절 탈구를 동반한 오구 돌기 골절의 봉합나사를 이용한 수술적 치료 - 증례 보고 -)

  • Jeong, Woon-Seob;Lee, Sang-Soo;Yoo, Yon-Sik;Kim, Do-Young;Park, Keun-Min
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.240-244
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    • 2009
  • Purpose: This study examined the outcomes of closed reduction and fixation of the coracoid process fracture using a suture anchor in a patient with combined acromioclavicular dislocation for which the coraco-clavicular ligament was intact. Materials and Methods: A 26 year-old male patient with a coracoid process fracture that was associated with a type III acromioclavicular joint dislocation was operated on with anchor suture fixation. This is the first trial of this operative procedure. Results: At the postoperative follow-up at 3 months, complete union of the coracoid process fracture was seen. The shoulder had a full range of motion and the shoulder function was normal. Conclusion: Closed reduction and fixation using one suture anchor for treating coracoid process fracture is a safe, effective procedure.

Treatment Results of Capitellum Fractures (상완골 소두 골절의 치료결과)

  • Park, Jin-Soo;Chung, Yung-Khee;You, Jung-Han;Noh, Gyu-Cheol;Chung, Kook-Jin;Jung, Sung-Ook
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.4 no.2
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    • pp.116-121
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    • 2005
  • Purpose: Isolated capitellar fractures are rare, intra-articular fractures requiring an aggressive management regimen. Review the outcome after open reduction and internal fixation of the capitellar fractures. Materials and Methods: From 1998 to 2004, 4 patients with displaced fractures of the humeral capitellum were treated by open reduction and internal fixation of the capitellar fragments with cannulated screws. By use of the criteria of Bryan and Morrey et al, there were 3 type I fractures, 1 type III fracture. A lateral approach was used. The elbows were immobilized postoperatively for 4 to 28 days We evaluated the range of motion, stability, and pain using the criteria of Mayo score. Results: The follow-up period ranged from 12 to 36 months (mean, 15months). Three patients had a stable, pain-free elbow with good range of motion at follow-up. One patient with a neglected capitellar fracture have felxtion cpontracture of 40 degrees with 100 degrees of further felxion(total arc: 60) due to poor compliance to the postoperative rehabilitation. All fractures healed, and there was no evidence of avascular necrosis or degenerative change. Conclusion: Capitellar fractures, rare in case, gave a good result after open reduction and simple internal fixation with cannulated screws without any problem.

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