• 제목/요약/키워드: Comminuted fractures

검색결과 93건 처리시간 0.036초

원위 경골 골절의 수술적 치료 (Surgical Treatment of Distal Tibia Fractures)

  • 정재중;강도준
    • 대한족부족관절학회지
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    • 제17권3호
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    • pp.174-181
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    • 2013
  • Distal tibia fractures were mainly caused by high energy trauma and the lower legs were enveloped in poor soft tissue. Therefore, there are many open fractures and concomitant soft tissue injuries in distal tibia fractures. For the restoration of ankle function, the surgical treatment was performed in distal tibia fractures. However, it is difficult to treat the distal tibia fracture surgically. There are many complications in distal tibia fracture due to highly comminuted fracture and poor soft tissue condition. There are many surgical methods for distal tibia fractures, such as, external fixator, intramedulary nailling, open reduction & internal fixation, and minimally invasive plate osteosynthesis. We reviewed the surgical treatments of distal tibia fractures.

Acute limb shortening and modified pantarsal arthrodesis for the treatment of a highly comminuted distal tibial articular fracture in a dog

  • Bruno Santos;Ines Gordo;Ronan Mullins
    • Journal of Veterinary Science
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    • 제24권2호
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    • pp.28.1-28.7
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    • 2023
  • A three-year-old female spayed Lurcher was referred for the treatment of a highly comminuted distal tibial articular fracture. Resection of the area of comminution with a transverse osteotomy of the tibial diaphysis and talar ridges was performed, followed by modified pantarsal arthrodesis and a calcaneotibial screw. The treatment resulted in 7 cm of tibial shortening, equating to a 28% reduction in the total tibial length. Radiographic union of the arthrodesis was successful. Fair use of the pelvic limb was documented long-term. Combined acute limb shortening and modified pantarsal arthrodesis resulted in an acceptable outcome and could be considered in cases of highly comminuted distal tibial fractures.

An Anterior Approach to Entire Length of Humerus and to Distal Shaft for Fracture Fixation

  • Lee, Chul-Hyung;Choi, Hyun;Kim, Tae-In;Kim, Jun Beom;Shin, Sang Yeop;Rhee, Seung-Koo
    • Clinics in Shoulder and Elbow
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    • 제19권4호
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    • pp.223-228
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    • 2016
  • Background: The aim of study was to confirm the clinical effectiveness and results of wide and single anterior approach for fractures occurring along length of humerus. Methods: A total of 23 patients with humeral fracture were enrolled into our study who were able to participate in at least one year of follow-up. Seven patients had segmental comminuted humeral fractures and 16 patients had distal humeral fractures. We made various tractions of the muscles to expose the proximal and the middle third humerus between the biceps and brachialis and the distal humerus by partial splitting of lateral side of biceps through a single incision. Postoperatively, we measured the Mayo elbow performance index (MEPI). Results: we achieved bone union in all 23 patients. Solid union of the bone was achieved at an average 13.9 weeks. Postoperatively, two complications were observed screw loosening and nonunion. Revision surgery was performed in both patients. The patient with bone nonunion was treated using bone grafts. No postoperative infections or peripheral neuropathies were observed. At the final follow-up (average 20 months), we found that the average MEPI functional score of the patients was 91.7 points regardless of the fracture site. Conclusions: Our whole humerus with a single incision was effective for the treatment of segmental comminuted and distal fractures. we believe it is a useful alternative to preexisting methods of fracture fixation.

Application of Plate and Circumferential Wiring with Resin to Bilateral Mandibular Fractures in a Calf: Case Report

  • Yu, Yong;Kim, Namsoo;Heo, Suyoung
    • 한국임상수의학회지
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    • 제37권6호
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    • pp.363-366
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    • 2020
  • A 2-month-old, 50 kg male Korean native calf was referred with bilateral mandibular fractures. The bilateral mandible was hanging loose, with inability to use the jaw, indicated by excessive salivation. Radiography revealed a long oblique fracture in the right mandible, and a short oblique fracture in the left mandible. Computerized Tomography, a different form of radiography, revealed the fracture in the left mandible to be a comminuted fracture. In order to stabilize the bilateral mandible fractures, a combination of bone plate and wiring was applied; in addition, resin was applied to enhance stabilization of the mandible. Six weeks after surgery, the calf was able to masticate and ruminate well. In this case, application of the plate and wiring with resin to bilateral mandibular fractures presented a successful functional recovery. Accordingly, the combination of bone plate and wiring with resin can be an effective technique for treating mandibular fractures.

Single-Stage Reconstruction with Titanium Mesh for Compound Comminuted Depressed Skull Fracture

  • Eom, Ki Seong
    • Journal of Korean Neurosurgical Society
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    • 제63권5호
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    • pp.631-639
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    • 2020
  • Objective : Traditionally, staged surgery has been preferred in the treatment of compound comminuted depressed fracture (FCCD) after traumatic brain injury (TBI) and involves the removal of primarily damaged bone and subsequent cranioplasty. The main reason for delayed cranioplasty was to reduce the risk of infection-related complications. Here, the author performed immediate reconstruction using a titanium mesh in consecutive patients with FCCD after TBI, reported the surgical results, and reviewed previous studies. Methods : Nineteen consecutive patients who underwent single-stage reconstruction with titanium mesh for FCCD of the skull from April 2014 to June 2018 were retrospectively analyzed. The demographic and radiological characteristics of the patients with FCCD were investigated. The characteristics associated with surgery and outcome were also evaluated. Results : The frequency of TBI in men (94.7%) was significantly higher than that in women. Most FCCDs (73.7%) occurred during work, the rest were caused by traffic accidents. The mean interval between TBI and surgery was 7.0±3.9 hours. The median Glasgow coma scale score was 15 (range, 8-15) at admission and 15 (range, 10-15) at discharge. FCCD was frequently located in the frontal (57.9%) and parietal (31.6%) bones than in other regions. Of the patients with FCCDs in the frontal bone, 62.5% had paranasal sinus injury. There were five patients with fractures of orbital bone, and they were easily reconstructed using titanium mesh. These patients were cosmetically satisfied. Postoperatively, antibiotics were used for an average of 12.6 days. The mean hospital stay was 17.6±7.5 days (range, 8-33). There was no postoperative seizure or complications, such as infection. Conclusion : Immediate bony fragments replacement and reconstruction with reconstruction titanium mesh for FCCD did not increase infectious sequelae, even though FCCD involved sinus. This suggests that immediate single-stage reconstruction with titanium mesh for FCCD is a suitable surgical option with potential benefits in terms of cost-effectiveness, safety, and cosmetic and psychological outcomes.

상완골 근위부 분쇄 골절에서의 상완골 두 치환술 (Hemiarthroplasty for the Comminuted Fracture of the Proximal Humerus)

  • 서중배;원중희;김용민;최의성;이호승;홍윤철
    • Clinics in Shoulder and Elbow
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    • 제3권2호
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    • pp.61-67
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    • 2000
  • Purpose: Most proximal humeral fractures are minimally displaced and can be treated satisfactorily with a conservative method. But in many comminuted fractures, hemiarthroplasty is usually done as a primary treatment. The authors evaluated how much functional improvement was achieved after hemiarthroplasty and which factors influence on the final functional results. Materials and Methods: Eleven hemiarthroplasties were performed for three- and four-part fractures(including fracture-dislocation) between April 1992 and June 1999. There were eight women and three men, and the mean age was 65 years. According to Neer classification, six was three-part fracture and five was four-part fracture. Six patients were injured on their right shoulder and five on the left shoulder. Among the five four-part fractures, three had axillary nerve injury and among the six three-part fractures, only one patient had axillary nerve injury. The average follow-up period was 2.4 years(1 year-7 years) after operation. The functional results were evaluated with the UCLA scoring system(Modification for hemiarthroplasty). In addition to the overall results, we compared the results according to the classification of the fracture, the cause of injury, and whether the axillary nerve was injured. Results: At the last follow-up, average total UCLA score was 18.2. The mean score for pain was 7.0, mean muscle power and motion score was 5.5 and 5.7 respectively. The pain relief was more satisfactory than any other functional results. The average score for three-part fractures was 22, and the average for four-part fractures was 13.6. The average score for the patients fractured by vehicle accidents was 15.3, and 19.3 for the patients fractured by slip-down injury. In patients without axillary nerve injury, the average score was 20, and with axillary nerve injury, the score was 15. Conclusion: Shoulder hemiarthroplasty, for the treatment of proximal humeral fractures, cannot restore the shoulder function to normal, but can achieve the functional result to some degree, especially for the activity of daily living. And as for pain, we think that it is relatively effective measure. And we think that the severer the comminution, the more the chance of axillary nerve injury, and the poorer the functional results. In conclusion, the severity of initial injury seems to be the major prognostic factor.

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대량의 골 및 연부조직 결손을 동반한 분쇄 경골 골절에서의 급성 단축술과 점진적 연장술 - 증례 보고 - (Acute Shortening and Gradual Lengthening for a Comminuted Tibia Fracture with Massive Bone and Soft Tissue Defect - Case Report -)

  • 한호성;허정규;송철호;백구현;이영호;공현식
    • Archives of Reconstructive Microsurgery
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    • 제20권1호
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    • pp.68-73
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    • 2011
  • Traditional management of comminuted tibia fractures with massive bone and soft tissue defect includes soft tissue coverage and bone grafting. However, this method requires a large flap and a substantial amount of bone graft. Acute shortening can reduce the amount of required soft tissue and bone graft. We report a case of open tibia and fibula fracture with severe bone and soft tissue defect that was successfully treated by acute shortening of the tibia with immediate fibular strut bone graft and then by gradual lengthening of the tibia at its proximal metaphysis.

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Surgical Treatment of Ipsilateral Multi-Level Femoral Fracture Treated Using Antegrade Intramedullary Nail

  • Kim, Beom-Soo;Cho, Jae-Woo;Yeo, Do-Hyun;Oh, Jong-Keon
    • Journal of Trauma and Injury
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    • 제31권2호
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    • pp.96-102
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    • 2018
  • Ipsilateral fractures of proximal femur with shaft and condylar region are very rare. Current concept of management is based on fixation of each fracture as independent entity using separate fixation modalities for proximal and distal parts of femur. However, we considered that antegrade femoral nailing with cephalomedullary screw fixation is a good option for ipsilateral multi-level femoral fractures. Here, we present an experience of satisfactory treatment for ipsilateral femoral neck fracture, subtrochanteric fracture, comminuted shaft fracture with supracondylar fracture following road traffic accident.