• Journal of Trauma and Injury
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• v.23 no.1
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• pp.1-5
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• 2010

Purpose: To investigate the results of treatment of reverse oblique trochanteric fractures with compression hip screw. Methods: We reviewed the results of 12 cases of reverse oblique trochanteric fracture treated with compression hip screw from January 2000 to December 2006 which could be followed up for more than 1 year. The mean follow up period was 26 months (15~40). The mean age was 48 years old. Injury mechanism was composed of 6 cases of traffic accident and 6 cases of fall down. 8 persons were man. We investigated the union time, degree of neck-shaft angle change, amount of sliding of compression hip screw, complications, functional and clinical results. Results: 10 cases were united and the mean union time were 5 months (3~8). The mean neck-shaft angle change was 3.5 degrees (0~12). The amount of sliding of compression hip screw was 8.9 mm (2~24). There were six coxa vara, six leg due to coxa vara shortening, two nonunion, and one superficial infection. Unsatisfactory results of Jensen's social function score and Parker and Palmer's mobility score were studied. Conclusion: The results of treatment of reverse oblique trochanteric fractures with compression hip screw were relatively unsatisfied.

• Journal of Trauma and Injury
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• v.34 no.1
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• pp.50-56
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• 2021

Purpose: Fractures are common in the military population, but limited studies have investigated the incidence of fractures among Korean military personnel. Hence, this study aimed to clarify this issue. Methods: Eligible subjects were patients who had sustained a fracture and were registered in the N-DEMIS (the medical records system of participating hospitals) from June 2017 to May 2019. Fractures were categorized according to the fracture site, patients' age, sex, and type of duty. Results: In total, 23,687 patients with 23,981 fractures were included. There were 216 patients with multiple fractures, of whom 156 had fractures at two sites, 42 had fractures at three sites, and 18 had fractures at four sites. Of the 23,687 patients, 23,340 were men and 347 were women. The incidence of fractures in men and women was 12.96 per 1,000 person-years and 0.19 per 1,000 person-years, respectively. In terms of the broad location of fractures, the percentage of fractures was the highest in the hand, followed by the foot and lower leg. When the location of fractures was analyzed more specifically, the percentage of fractures was the highest in the phalanx (thumb and fingers), followed by the ankle and metacarpal bones. Conclusions: Hand, foot, ankle, and wrist fractures were the most commonly encountered fractures in the Korean military population. To prevent the loss of combat power due to non-battle-related injuries, thorough preparation is necessary, including protective equipment and preliminary training for areas with a high frequency of fracture occurrence.

• Journal of Korean Neurosurgical Society
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• v.38 no.2
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• pp.111-115
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• 2005

Objective : Upper lumbar disc herniation is rare disease, compared with lower. The lamina of this high level lumbar vertebra is narrower than that of low level, and this have taken surgeon into important consideration for surgical methods because partial removal of lamina for discectomy weakens the base of the articular process and may result in fracture. The authors an accurate preoperative diagnosis that enables the surgeon to operative approach for preserving the facet joint. Methods : Thirteen patients with upper lumbar disc herniation have underone surgical procedure by midline approach for removal of ruptured disc fragment and paraspinal approach for removal of residual disc materials simultaneously without instrumentation. All patients who underwent surgery were analyzed and long-term follow-up was conducted. Results : At a mean follow-up of 24months, there were complete resolution of presenting radiating leg pain in 85% of the patients, 7.5% were left with minimal residual discomfort, and 7.5% derived little or no benefit from surgery. The follow-up radiologic findings of all patients shows that lamina and facet joint have preserved safely and no instability. Conclusion : Simultaneously, paraspinal with midline approach provides highly satisfactory operating methods by simplifying exposure and greatly limiting the risk of complications. This provides the basis for a planned surgical approach in which destruction of the facet joint can be avoided.

• Journal of Veterinary Clinics
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• v.28 no.5
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• pp.467-472
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• 2011

This study was conducted to describe clinical presentation of pelvic fracture and compare clinical outcomes of each part of pelvic fractures in 54 client-owned dogs. There was an average of 3.61 pelvic fractures per dog and 47 dogs had more than two fractures. The average time until initial weight-bearing on the affected leg, hospitalization after surgery, and lameness score at final check in 31 dogs that underwent surgery were 7.04 days, 16.39 days, and 1.25, respectively, and there were no significant difference in the incidence of sacroiliac luxation, iliac fracture, and acetabular fracture among them. The length of hospitalization and the lameness score upon final check of the dogs with over two surgically repaired sites were significantly longer and higher than those of the dogs with one surgically repaired site (P = .043 and P = .008, respectively). Upon final check of the dogs with bilateral pelvic fracture that was surgically treated, the hospitalization and lameness score were significantly longer and higher than those of dogs with unilateral pelvic fracture that was surgically treated (P = .034 and P = .033), respectively. The number of pelvic fractures treated surgically appears to be a more influential factor influencing recovery from pelvic fractures than the location of the pelvic fractures.

• 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.

• 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.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.4
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• pp.337-338
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• 2007

A 20-year-old man underwent a Tc-99m HMPAO labeled leukocyte scan for the evaluation of an infection at the stump of an AK amputation, which was conducted due to an open communicated fracture of the left lower leg. Blood-flow and blood-pool images demonstrated a pseudoaneurysm with a focus of intense activity medial to the stump, and centered within a large photopenic defect by surrounding hematoma. Delayed image obtained at 3 hours post-injection showed persistent intense and slight increased activity, Contrast angiography confirmed the presence of a pseudoaneurysm arising from a branch of the left superficial femoral artery.

• Journal of Chest Surgery
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• v.52 no.3
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• pp.162-164
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• 2019

A male patient weighing 2.5 kg was admitted for respiratory difficulty, and a large ventricular septal defect (VSD) was diagnosed. During care, sudden right leg swelling with a femur shaft fracture occurred. The patient's father had a history of recurrent lower extremity fractures; thus, osteogenesis imperfecta was considered. The patient's respiratory difficulty became aggravated, and VSD repair in the neonatal period was therefore performed with gentle sternal traction and great vessel manipulation under total intravenous anesthesia to prevent malignant hyperthermia. The patient was discharged without notable problems, except minor wound dehiscence. Outpatient genetic testing revealed that the patient had a COL1A1/COL1A2 mutation.

• Archives of Plastic Surgery
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• v.46 no.6
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• pp.589-593
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• 2019

Post-traumatic defects of the distal third of the leg often require skipping a few steps of the well-established reconstructive ladder, due to the limited local reliable reconstructive options. In rare cases, the reconstructive plan and flap choice may encounter challenges when the patient has psychiatric illness affecting compliance with postoperative care. We describe a case of a patient with severe intellectual disability and an open fracture of the distal lower limb. After fracture management and debridement of devitalized tissues, the resultant soft tissue defect was covered with a free gracilis flap. On postoperative day 7, the patient ripped out the newly transplanted flap. The flap was too traumatized for salvage, so a contralateral free gracilis muscle flap was used. The patient showed good aesthetic and functional outcomes at a 1-year follow-up. When planning the postoperative management of patients with psychiatric illness, less complex and more robust procedures may be preferred over a long and complex surgical reconstruction requiring good compliance with postoperative care. The medical team should be aware of the risk of postoperative collapse, focus on the prevention of pain, and be wary of drug interactions. Whenever necessary, free tissue transfer should be performed despite potential compliance issues.

• Archives of Reconstructive Microsurgery
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• v.16 no.1
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• pp.6-13
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• 2007

Purpose: To report the clinical results of the vascularized fibular graft in the treatment of intractable infected nonunion of femur. Materials and Methods: We reviewed 3 patients who were performed vascularized fibular graft in treated for intractable infected nonunion of femur. They had received an average of 5.6 times($4{\sim}8\;times$) surgical treatment at different hospitals. 1 case was of a infected nonunion in a fracture treated with internal fixation, the fracture having occurred after resection of a malignant tumor and transplantation of pasteurized autologous bone. 2 cases occurred after internal fixation in closed fractures. Surgical treatment was performed an average of 4 times($3{\sim}5\;times$) at our hospital and in all of the cases debridement of necrotic tissue and sequestrectomy. And vascularized fibular graft was performed. In all cases unilateral external fixation devices were used, of these, 1 case was changed into internal fixation. The final conclusion was made by assessment of functional outcomes and complications according to the standards of Paley. Results: As a result, in all of the cases bone union was achieved, and in the last follow up the functional results were excellent in 2 cases and good in 1 case. There were not presented leg length discrepancy of more than 2 cm, and further loss of knee joint motion. After previous treatment, average 23.3 months($16{\sim}30\;months$) was taken to eliminate infection and achieve complete bone union via vascularized fibular graft in our hospital. Conclusion: In treatment of intractable infected nonunion of femur, fairly good results can be expected after firm fixation, through debridement and vascularized fibular graft.