• Title/Summary/Keyword: 하지골절

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Dual Plate Fixation for Displaced Transverse Fracture of the Lower Sacrum (전위된 하부 천골 횡골절에 대한 이중 금속판을 이용한 내고정술)

  • Choi, Dong-Hyuk;Park, Ji-Hun;Shim, Seong-Woo;Choi, Yong-Soo
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.178-182
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    • 2020
  • Isolated fractures of lower sacrum are commonly treated conservatively in most cases because of low energy damage and stable fracture. However, surgical treatment is required in displaced unstable fracture. But the surgical technique is not established and even case reports are not common. We reported a case of displaced transverse fracture of the lower sacrum that was treated with an open reduction and dual plate fixation.

Glenoid lesion in Traumatic Anterior Instability of Shoulder (견관절 외상성 불안정성 관절와 병변)

  • Lee, Seoung-Joon;Park, Jin-Young;Keum, Jung-Sup;Ye, Meng
    • Clinics in Shoulder and Elbow
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    • v.10 no.1
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    • pp.23-26
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    • 2007
  • 관절와 병변은 급성 외상으로 인한 골절뿐 아니라 불안정성으로 인한 골 침윤으로 정의할 수 있으며, 이는 통상의 방사선학적 검사를 통하여 진단을 하지 못하는 경우도 있다. 전방 탈구와 동반된 전방 관절와 골절의 빈도는 5.4%에서 32%까지 보고되었다. Hovelius 등이 226명의 탈구환자를 대상으로한 연구에서 8%의 관절와 골절이 있었다고 보고하였고, 노령의 환자에서 약간의 빈도가 증가한다고 하였다. 또한 Rowe는 전방 관절와 골절이 있는 27명의 환자에서 기계적 안정성의 결함으로 62%의 재발성 탈구가 있었다고 보고하였다. 보다 최근의 방카르트 술기에 대한 보고에서 수술적 처치를 한 환자중 44%가 관절와 골절을 동반하였다고 보고하였다. Rowe 와 Zarins는 다발성 전방탈구 환자에서 관절와 병변이 잘 치료되었는지 여부에 따라 다른 결과를 낸다고 보고하였다. 전자에 따르면, 관절와 병변을 진단하는 것은 중요하며 환자의 최종적 예후는 이를 어떻게 치료했는지 여부에 따라 결정된다고 하였다. 관절와 상완관절의 불안정성에서 동반된 관절와 병변의 진단은 보존적 치료시나 수술적 치료 시 모두 중요한 인자라고 하겠다.

Nonunion of Tibial Eminence Fracture in Child - 2 cases Report - (소아 경골 극 골절의 불유합 - 2예 보고 -)

  • Hur, Yoon-Moo;Chung, Whan-Yong;Kim, Sang-Bum;Kim, Sung-Hun;Rhu, Seung-Reol
    • Journal of the Korean Arthroscopy Society
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    • v.10 no.2
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    • pp.192-198
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    • 2006
  • The general consensus is that tibial eminence fractures have an excellent prognosis. But symptomatic nonunions requiring reduction and grafting have been reported. This report presents two cases of nonunion after tibial eminence fracture in eight years old boys which were treated with arthroscopy-guided reattachment and internal fixation and obtained good outcome.

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A Basic Design and Characterization on Composite Bone Plate for Bone Fracture Healing (골절 치료를 위한 복합재료 고정판 기초 설계 및 특성 평가)

  • Kim, Ju-Ho;Chang, Seung-Hwan
    • Composites Research
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    • v.20 no.5
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    • pp.7-12
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    • 2007
  • This paper aims to enhance the efficiency of bone fracture healing with bone plate made of fiber reinforced composite materials. The composite bone plate was designed as the same dimension and shape as the existing stainless steel bone plate. To find out the appropriate stacking sequence of the composite bone plate the variations of strain distributions were calculated using FE analysis when the bone plates were applied to the fracture site. From the analysis result it was found that the composite bone plate whose Young's modulus is lower than that of metal bone plate gave more uniform strain distribution and provided appropriate condition for callus formation and its development.

Surgical Treatment of Metastatic Pathologic or Impending Pathologic Fractures (전이성 병적 골절 또는 병적 임박 골절의 수술적 치료)

  • Kim, Kap-Jung;Lee, Sang-Ki;Choy, Won-Sik;Seo, Dong-Wook
    • The Journal of the Korean bone and joint tumor society
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    • v.15 no.1
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    • pp.44-51
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    • 2009
  • Purpose: We evaluated the results of surgical treatment for metastatic pathologic or impending pathologic fractures. Materials and Methods: From January 2004 to December 2007, 18 patients 19 cases were included. Male were 6 and female were 12. The mean age was 65.1. Mean follow up period was 15.2 months. Pathologic fractures were 14 and impending pathologic fractures were 5. MSTS score, periodic radiologic follow up and postoperative complications were evaluated. Results: The primary malignancies were 6 cases of multiple myeloma, 4 cases of renal cell carcinoma, 2 cases of cholangiocarcinoma, 2 cases of colon cancer, 2 cases of breast cancer and 2 cases of leiomyosarcoma. Metastatic lesions were 10 cases of femur, 4 cases of clavicle, 2 cases of humerus, 2 cases of tibia and 1 case of radius. Surgical options were curettage, cementation, internal fixation and arthroplasty. Mean MSTS score was 15.9. Postoperative complications were 1 case of infection, 1 case of local recurrence and 1 case of implant loosening. Ten patients were alive with disease, 8 patients died of disease. Conclusion: Surgical treatment of metastatic skeletal lesions allowed early ambulation and improving dexterity. It improved pain and emotional acceptance. Surgery is necessary for improving qualities of remaining lives.

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Ultrasonography in Radial Nerve Palsy after Surgery of Humerus Shaft Fracture - Case Report - (상완골 간부 골절 수술 후 발생한 요골신경 마비에서 시행한 초음파 검사 -증례 보고-)

  • Yoon, Hyungmoon;Kho, Dukhwan;Kim, Hyeungjune;Nam, Kyoungmo;Kang, Daemyung
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.5 no.2
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    • pp.106-112
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    • 2012
  • Radial nerve palsy after surgery of humerus fracture is uncommon complication. Occasionally it needs operative treatment because of difficulty to accurate evaluation. We report this case of radial nerve palsy after surgery of humerus shaft fracture with ultrasound examination. We checked the continuity of radial nerve and radial nerve palsy was complete recovered with conservative treatment.

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A Clinical Analysis of Femur Neck Fracture in Elderly Patients (노년층에서 대퇴경부 골절의 치료)

  • Ihin, Joo-Choul;Ahn, Myun-Whan;Seo, Jae-Sung
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.11-22
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    • 1985
  • Femur neck fracture is well known as one of the major death cause after trauma in elderly patients, and unsolved fracture due to its frequent association with complications such as avascular necrosis and nonunion. Through meticulous evaluation of the patient, hip and surgeon's experiences, reduction of mortality and morbidity as well as rapid recovery of the patient to the preinjury social and ambulatory status without local complications and revision after treatment is urgently needed. Many factors about this fracture In itself were noted, but we have analyzed 18 femur neck fractures of the patients older than 50 years preliminarily according to age, fracture pattern, osteoporosis, etiology and method of treatment with its delay in association with major complications especially avascular necrosis and nonunion. The results are as follows; 1. Of these 18 fractures, 11 were in females, 8 were caused by minor trauma such as slip-down accident and 4 were associated with definite osteoporosis according to the Sing's classification. 2. Fracture pattern of these 18 are undisplaced in 4, displaced subcapital in 11, displaced transcervical in 3. 11 fractures in the patients older than 60 year are composed of 3 undisplaced or impacted fractures and 8 displaced subcapital fractures. 3. These 18 fractures were treated by closed reduction and Internal fixation with multiple pins in 13, and hemiarthroplasty in 4, but one was not treated to die after discharge from hospital. 4. 4 undisplaced or impacted fractures and 3 displaced transcervical fractures were not associated with any complications such as avascular necrosis or nonunion. But 4 of 6 displaced subcapital fractures were complicated by avascular necrosis, 3 of which were reduced in the varus position within 1 week, and the other was reduced in the good position on 1 week after trauma. There was no complication in 2 displaced subcapital fractures reduced in valgus position within 3 days after trauma. According to the above results, the prognosis of the femur neck fracture is dependent upon the fracture pattern and delay in its treatment. So it is inevitable to reduce the fracture in anatomical or valgus position as early as possible. But the arthroplasty may be needed in displaced subcapital fractures delayed for several days, with its reluction in extreme varus position or impossible and with pre-existing disease in the same hip Joint (total hip replacement).

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Reverse Superficial Sural Artery Flap for the Reconstruction of Soft Tissue Defect Accompanied by Fracture of the Lower Extremity (하지 골절과 동반된 연부조직 결손 재건을 위한 역행성 비복동맥 피판술)

  • Han, Soo-Hong;Hong, In-Tae;Choi, SeongJu;Kim, Minwook
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.3
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    • pp.253-260
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    • 2020
  • Purpose: Soft tissue defects of the distal lower extremity are commonly accompanied by a fracture of the lower extremities. Theses defects are caused by the injury itself or by complications associated with surgical treatment of the fracture, which poses challenging problem. The reverse superficial sural artery flap (RSSAF) is a popular option for these difficult wounds. This paper reviews these cases and reports the clinical results. Materials and Methods: Between August 2003 and April 2018, patients who were treated with RSSAF for soft tissue defects of the lower third of the leg and ankle related to a fracture were reviewed. A total of 16 patients were involved and the mean follow-up period was 18 months. Eight cases (50.0%) of the defects were due to an open fracture, whereas the other eight cases (50.0%) were postoperative complication after closed fracture. The largest flap measured 10×15 cm2 and the mean size of the donor sites was 51.9 cm2. The flap survival and postoperative complications were evaluated. Results: All flaps survived without complete necrosis or failure. One case with partial necrosis of the flap was encountered, but the wound healed after debridement and repair. One case had a hematoma with a pseudoaneurysmal rupture of the distal tibial artery. On the other hand, the flap was intact and the wound healed after arterial ligation and flap advancement. A debulking operation was performed on three cases for cosmetic reasons and implant removal through the flap was performed in three cases. No flap necrosis was encountered after these additional operations. Conclusion: RSSAF is a relatively simple and safe procedure for reconstructing soft tissue defects following a fracture of the lower extremity that does not require microsurgical anastomosis. This can be a useful treatment option for soft tissue defects on the distal leg, ankle, and foot.

Cauda Equina Syndrome after Percutaneous Balloon Kyphoplasty for Pathologic Compression Fracture (병적 척추체 압박 골절 환자에서 경피적 풍선 척추 성형술 시행 후 발생한 마미 증후군)

  • Park, Sung Jun;Park, Myung Hoon;Park, Jae Woo;Cho, Kyu Jung
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.1
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    • pp.90-94
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    • 2020
  • Percutaneous balloon kyphoplasty is an option for pain relief in pathological vertebral compression fractures. Complications related to cement leakage through cortical defects have been reported. On the other hand, dural compression due to retropulsion of the tumor mass is rarely reported. The authors report a case of a 65-year female patient who had cauda equina syndrome after a percutaneous balloon kyphoplasty in a pathological vertebral fracture, even though epidural compression were not found prior to surgery. Magnetic resonance imaging revealed retropulsion of the tumor mass into the spinal canal through the disrupted posterior vertebral cortex.